Individual
JOSEPH F MAZZA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12640 CREEKSIDE LN, FT MYERS, FL 33919-3359
(239) 482-7676
(239) 482-7604
Mailing address
12640 CREEKSIDE LN, FT MYERS, FL 33919-3359
(239) 482-7676
(239) 482-7604
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME42670
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001572600
—
FL
01
—
07873
BLUE CROSS BLUE SHEILD
FL
Enumeration date
03/16/2006
Last updated
06/22/2021
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