Healthcare Provider Details

I. General information

NPI: 1053226043
Provider Name (Legal Business Name): MR. PHILLIP COLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13209 LAUREN DR
SPRING HILL FL
34609-1565
US

IV. Provider business mailing address

13209 LAUREN DR
SPRING HILL FL
34609-1565
US

V. Phone/Fax

Practice location:
  • Phone: 727-273-5151
  • Fax:
Mailing address:
  • Phone: 727-273-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW27081
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSW27081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: