MR. IVAN A MUSTAFA, ARNP
Nursing at Dixie Ave, Leesburg, FL

License number
Florida ARNP3098742
Category
Nursing
Type
Nurse Practitioner
Address
Address 2
600 E Dixie Ave, Leesburg, FL 34748
8490 NE 150Th Ave, Williston, FL 32696
Phone
(352) 323-5762
(407) 758-4104
National Provider ID: 1497727804
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about IVAN A MUSTAFA at bizstanding.com

IVAN A. MUSTAFA, ARNP-C, PA

8490 NE 150 Ave, Williston, FL 32696

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jan 7, 2004
Inactive since:
Sep 15, 2006
State ID:
P04000005726
Business type:
Florida Profit Corporation
President, Secretary, Director:
Ivan A Mustafa President, Secretary, Director, inactive, 8490 NE 150 Ave, Williston, FL 32696 (Physical)
Agent:
Ivan Mustafa,8490 NE 150 Ave, Williston, FL 32696 (Physical)
EIN:
20-0585220

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