Individual
KATHLEEN P SOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
725 VIRGINIA STREET, DUNEDIN, FL 34698-6615
(727) 734-4551
(727) 736-8648
Mailing address
4651 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 321-1786
(813) 321-1787
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS8204
FL
207N00000X
Dermatology Physician
Primary
OS8204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293930
AVMED
FL
01
—
3491438
AETNA HMO
FL
01
—
6272360
CIGNA
FL
01
—
7881565
AETNA PPO
FL
Enumeration date
10/21/2005
Last updated
09/02/2021
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