IVAN L MAZZORANA, MD
Psychiatric at Whitehall Dr, Fort Myers, FL

License number
Florida ME00623151
Category
Psychiatric
Type
Psychiatry
Address
Address
12590 Whitehall Dr STE 3, Fort Myers, FL 33907
Phone
(239) 939-9090
(239) 939-2922 (Fax)
National Provider ID: 1669480653
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about IVAN L MAZZORANA at bizstanding.com

Jr Ivan L Mazzorana MD

12590 Whitehall Dr, Fort Myers, FL 33907

Industry:
Medical Doctor's Office
Phone:
(239) 939-9090 (Phone)
Allied Health Professionals:
Ivan Mazzorano (Psychiatry, President, Medical Doctor),Kathy Lewis (Office Manager),Angela Monterosso (Nurse Practitioner),...

IVAN L. MAZZORANA, JR., M.D., PA

Fort Myers, FL

Registration:
May 13, 1997
Addresses:
12590 Whitehall Dr SUITE 3, Fort Myers, FL 33907 (Physical)
12891 Magnolia Pointe Ct, Fort Myers, FL 33919 (Mailing)
State ID:
P97000042281
Business type:
Florida Profit Corporation
Director:
Ivan Ljr Mazzorana (Director), 12891 Magnolia Pointe Ct, Fort Myers, FL 33919 (Physical)
Agent:
Ivan Mazzorana,12891 Magnolia Pointe Ct, Fort Myers, FL 33919 (Physical)
EIN:
65-0752131

Psychiatric licenses in Florida