Healthcare Provider Details

I. General information

NPI: 1265060073
Provider Name (Legal Business Name): COLE RYAN BILLENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

3100 WESTON RD
WESTON FL
33331-3602
US

V. Phone/Fax

Practice location:
  • Phone: 866-223-8100
  • Fax:
Mailing address:
  • Phone: 866-223-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME183387
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.154369
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: