Individual
DR. KATHRYN SUSANNE BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
UO4129
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/26/2014
Last updated
10/08/2017
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