Ivan L Mazzorana Jr Md Pa

LBN: Ivan L Mazzorana Jr Md Pa
Ivan L Mazzorana Jr Md Pa is an health care organization with primary practice located at 12590 Whitehall Dr Suite 3, Ft Myers FL 33907-3620. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Ivan L Mazzorana Jr Md Pa can be contacted via phone (239) 939-9090, or through Mazzorana, Ivan L via phone (239) 939-9090.

Contact Information

Primary practice address
12590 Whitehall Dr Suite 3 Ft Myers FL 33907-3620
Phone: (239) 939-9090
Fax: (239) 939-2922
Website:
Map and Directions
Authorized official contact:
Name: Mazzorana, Ivan L Doctor of Medicine (MD)
Phone: (239) 939-9090

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1790877488
LBN Legal business name Ivan L Mazzorana Jr Md Pa
DBA Doing business as
Authorized official Mazzorana, Ivan L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2006
Last updated Nov 15th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790877488 NPPES
Other 3189574 GHI
Other 990014183 GHI

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