MEDICARE: NATIONAL CARDIAC AND VASCULAR CONSULTANT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1013885029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL CARDIAC AND VASCULAR CONSULTANT LLC

Provider Business Mailing Address
First Line	:	310 NESBIT ST
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-3828
Country	:	US
Telephone Number	:	941-559-8995
Fax Number	:	941-559-8996

Provider Business Practice Location Address
First Line	:	310 NESBIT ST
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-3828
Country	:	US
Telephone Number	:	941-559-8995
Fax Number	:	941-559-8996

Authorized Official
Title or Position	:	OWNER
Name	:	JIHAD ALI MUSTAPHA
Credential	:	MD
Telephone Number	:	941-559-8995

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	12/05/2025

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