Healthcare Provider Details
I. General information
NPI: 1316929771
Provider Name (Legal Business Name): WILLIAM J COLE JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/18/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4071 BEE RIDGE RD SUITE 101
SARASOTA FL
34233-2550
US
IV. Provider business mailing address
4071 BEE RIDGE RD SUITE 101
SARASOTA FL
34233-2550
US
V. Phone/Fax
- Phone: 941-371-7171
- Fax: 941-371-7474
- Phone: 941-371-7171
- Fax: 941-371-7474
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | OS8697 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: