=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124944616
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTINE ANITA COLE LDO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2026
-----------------------------------------------------
Last Update Date | 06/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3921 SW COLLEGE RD
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34474-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-873-1000
-----------------------------------------------------
Fax | 352-873-9414
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6412 N TAMARIND AVE
-----------------------------------------------------
City | HERNANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34442-2279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-415-2075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 156FX1800X
-----------------------------------------------------
Taxonomy Name | Optician
-----------------------------------------------------
License Number | 4243
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------