MEDICARE: MR. PERRY J COLE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME83999	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	62728	OTHER	FL	BCBS
3	614424600	OTHER	FL	OWCP - FECA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053417428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PERRY J COLE M.D.

Provider Business Mailing Address
First Line	:	3100 UNIVERSITY BLVD S
Second Line	:	SUITE 300
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2742
Country	:	US
Telephone Number	:	904-274-8813
Fax Number	:	904-503-4465

Provider Business Practice Location Address
First Line	:	3100 UNIVERSITY BLVD S
Second Line	:	SUITE 300
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2742
Country	:	US
Telephone Number	:	904-274-8813
Fax Number	:	904-503-4465

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	05/07/2024

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Directions to “ MR. PERRY J COLE M.D.” Practice Location

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