Organization
IVORA INC
Active
Other names
Fia Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M FABIANO (CEO)
(954) 702-3372
Entity
Organization
Contact information
Practice address
13894 S BANGERTER PKWY STE 200, DRAPER, UT 84020-5320
(801) 901-3603
Mailing address
10885 S LOSTWOOD DR, SANDY, UT 84092-4925
(954) 702-3372
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
11/06/2020
Last updated
02/16/2022
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