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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790877488 | NPPES |
| Other | 3189574 | GHI | |
| Other | 990014183 | GHI |
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