Individual
MARGUERITE MARY KOHLHEPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
403 VONDERBURG DR, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Mailing address
403 VONDERBURG DR, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME0076125
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
ME76125
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264786900
—
FL
01
—
3353345
CIGNA
FL
01
—
58545
BCBSFL
FL
01
—
7514064
AETNA
FL
01
—
9666437
GHI
NY
Enumeration date
07/22/2005
Last updated
05/18/2020
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