Provider Demographics
NPI:1902285240
Name:GRUZINOVA, IRINA (MD)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:GRUZINOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF FLORIDA COM - ROOM G347
Mailing Address - Street 2:BOX 100374
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0374
Mailing Address - Country:US
Mailing Address - Phone:352-265-0438
Mailing Address - Fax:352-265-0592
Practice Address - Street 1:1515 SW ARCHER RD
Practice Address - Street 2:UNIVERSITY OF FLORIDA COM RADIOLOGY DEPARTMENT
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1134
Practice Address - Country:US
Practice Address - Phone:352-265-0438
Practice Address - Fax:352-265-0592
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1463522085R0202X
AZR75029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology