Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 108930 | FL |
Y | 207SG0201X | Clinical Genetics (M.D.) | ME108930 | FL |
N | 208000000X | Pediatrician | 108930 | FL |
NPI | 1043468648 |
---|---|
Provider Name | Dr. Kathleen Margaret O'connell Pope |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Orlando, FL 32827-7402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 26/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004642500 | (05) | FL |
14JP2 | BLUE CROSS BLUE SHIELD (01) | FL |