Healthcare Provider Details

I. General information

NPI: 1801454632
Provider Name (Legal Business Name): IRINA NAGOVSKY COOLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRINA NAGOVSKY MD

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-3437
  • Fax:
Mailing address:
  • Phone: 813-821-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME155671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: