Individual
KATHERINE JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(888) 663-3488
Mailing address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
60763-20
WI
208M00000X
Hospitalist Physician
60763-20
WI
208M00000X
Hospitalist Physician
Primary
ME 121033
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720244502
—
WI
Enumeration date
07/31/2008
Last updated
04/06/2015
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