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NPI Code Detail

MEDICARE: MARILYN KOLE M.D.

MEDICARE: MARILYN KOLE 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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianME69317FL
2207RP1001XPulmonary Disease PhysicianME0069317FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669469011
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN KOLE M.D.
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-343-1262
Fax Number : 239-343-0290
Provider Business Practice Location Address
First Line : 13681 DOCTORS WAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4300
Country : US
Telephone Number : 239-343-1105
Fax Number : 239-343-1106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 03/29/2021

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