MEDICARE: JAIMIE COLE RDN, LDN

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	133V00000X	Registered Dietitian	6728	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1053906	OTHER		COMMISSION ON DIETETIC REGISTRATION

General Provider Information

NPI Number	:	1306460530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMIE COLE RDN, LDN

Provider Business Mailing Address
First Line	:	2019 SHADOW WALK
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2348
Country	:	US
Telephone Number	:	727-243-7979
Fax Number	:

Provider Business Practice Location Address
First Line	:	2019 SHADOW WALK
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2348
Country	:	US
Telephone Number	:	727-243-7979
Fax Number	:

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

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	04/17/2026

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