Healthcare Provider Details

I. General information

NPI: 1588260657
Provider Name (Legal Business Name): SHARON ELIZABETH COLE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 17TH ST UNIT 202
SAINT CLOUD FL
34769-4939
US

IV. Provider business mailing address

825 MCCULLOUGH AVE APT 306
ORLANDO FL
32803-7226
US

V. Phone/Fax

Practice location:
  • Phone: 407-530-5063
  • Fax:
Mailing address:
  • Phone: 813-764-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT36637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: