Individual
MR. IVAN A MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 323-5762
Mailing address
8490 NE 150TH AVE, WILLISTON, FL 32696-3842
(407) 758-4104
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP3098742
FL
Other
Enumeration date
02/02/2006
Last updated
01/28/2008
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