Ivan L Mazzorana Jr Md Pa
Psychiatry · Ft Myers, FL
At a glance
12590 Whitehall Dr, Ft Myers, FL 33907-3620
NPPES record updated Nov 15, 2012. Public records can lag behind changes at a practice.
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Practice location
12590 Whitehall Dr Suite 3Ft Myers, FL 33907-3620
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Psychiatry
- Taxonomy code
- 2084P0800X
- Enumeration date
- Sep 29, 2006
- Record updated
- Nov 15, 2012
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Psychologist
103T00000X
Psychiatry
2084P0800X · Primary
Specialty details in registry
363LP0808X
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
12590 Whitehall DrSuite 3
Ft Myers, FL 33907-3620
- Phone
- (239) 939-9090
- Fax
- (239) 939-2922
Mailing address
12590 WHITEHALL DRSUITE 3
FT MYERS, FL 339073620
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