Individual
IVAN L MAZZORANA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12590 WHITEHALL DR STE 3, FORT MYERS, FL 33907-4680
(239) 939-9090
(239) 939-2922
Mailing address
12590 WHITEHALL DR, STE 3, FT MYERS, FL 33907-3620
(239) 939-9090
(239) 939-2922
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME00623151
FL
Other
Enumeration date
08/04/2006
Last updated
10/04/2024
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