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Individual

MUHAMMAD R MUSTAFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1625 SE 3RD AVE STE 721, FORT LAUDERDALE, FL 33316-2521
(954) 831-7263
(954) 712-3970
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 831-2763
(954) 712-3970

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
268720
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
278103
NYS MEDICAL LICENSE
NY
05
3810012858
WV
01
ME146665
FLORIDA MEDICAL LICENSE
FL
01
MZ748
MEDICARE ID
FL
Enumeration date
08/04/2008
Last updated
07/28/2022
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