Basic Information
| Provider Information | |||||||||
| NPI: | 1902285240 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRUZINOVA | ||||||||
| FirstName: | IRINA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF FLORIDA COM - ROOM G347 | ||||||||
| Address2: | BOX 100374 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522650438 | ||||||||
| FaxNumber: | 3522650592 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 SW ARCHER RD | ||||||||
| Address2: | UNIVERSITY OF FLORIDA COM RADIOLOGY DEPARTMENT | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326081134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522650438 | ||||||||
| FaxNumber: | 3522650592 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 08/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R75029 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.