Healthcare Provider Details

I. General information

NPI: 1528564218
Provider Name (Legal Business Name): IRENE O GAMRA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-1711
US

IV. Provider business mailing address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 352-627-9350
  • Fax:
Mailing address:
  • Phone: 205-638-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42402
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberME169563
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME169563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: