Individual
KATHLEEN MOBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(305) 665-4614
Mailing address
PO BOX 60100, CHARLESTON, SC 29419-0100
(800) 664-3939
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME51280
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036185200
—
FL
01
—
04287
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/25/2006
Last updated
05/02/2012
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