Individual
ANGELICA M MAZZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6201 ALLIANCE LN STE 100, FORT MYERS, FL 33912-7164
(239) 343-1176
(239) 343-4238
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1176
(239) 343-4238
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
021573
NY
363A00000X
Physician Assistant
Primary
PA9114885
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115619200
—
FL
Enumeration date
11/02/2017
Last updated
08/21/2025
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