Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan L Mazzorana Jr MD PA

Organization Psychologist · NPI 1790877488

Ivan L Mazzorana Jr MD PA is a Psychologist in Ft Myers, Florida. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12590 Whitehall Dr Ste 3
Ft Myers, FL 33907-3620
Phone: (239) 939-9090
Fax: (239) 939-2922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Psychologist Taxonomy 103T00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1790877488
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ivan Mazzorana — President · (239) 939-9090
NPI enumeratedSeptember 29, 2006
Last updated in NPPESNovember 15, 2012
Mailing address12590 Whitehall Dr, Suite 3, Ft Myers, FL 33907-3620

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