| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AHMAD MUSTAFA AMANI | 1770875080 | 2023-11-10 |
Ahmad Mustafa Amani is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1770875080. Registration indicates Ahmad Mustafa Amani is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Surgery (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Ahmad Mustafa Amani M.D. |
| Practice Office Address | 8725 N WICKHAM RD STE 203 MELBOURNE, FL US |
| Practice Office Telephone | 3214349535 |
| Practice Office Fax | 3214349538 |
| Mailing Address | 3300 S FISKE BLVD ROCKLEDGE, FL 329554306 US |
| Business Telephone | 3214349235 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1223 Gateway Dr | Melbourne, FL 329012607 | 3213615577 / 3216769731 |
| Code | Practice | License No State |
|---|---|---|
| 208600000X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | ME150014
FL |
| N5720 | OTHER | FL | HFMG MA |
| 111326800 | MEDICAID | FL |