Healthcare Provider Details

I. General information

NPI: 1497909345
Provider Name (Legal Business Name): IVO JOE DRAZENOVIC NAVARRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16271 BASS RD
FORT MYERS FL
33908-3616
US

IV. Provider business mailing address

16271 BASS RD
FORT MYERS FL
33908-3616
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-7100
  • Fax: 394-687-9242
Mailing address:
  • Phone: 239-343-7100
  • Fax: 239-468-7924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number273301
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME157718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: