Provider Demographics
NPI:1093923336
Name:MUSTAFA, HELWEY (DO)
Entity Type:Individual
Prefix:
First Name:HELWEY
Middle Name:
Last Name:MUSTAFA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 CORPORATE CENTRE BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3217
Mailing Address - Country:US
Mailing Address - Phone:855-893-2298
Mailing Address - Fax:866-214-6824
Practice Address - Street 1:6545 CORPORATE CENTRE BLVD STE 240
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3217
Practice Address - Country:US
Practice Address - Phone:855-893-2298
Practice Address - Fax:866-214-6824
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT011199207R00000X
FLOS10252207RH0002X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000307000Medicaid
FLAQ173ZMedicare PIN