MEDICARE: DR. COLE ROBERT LINVILLE D.O.

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	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	OS14807	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D25HK	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851735377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLE ROBERT LINVILLE D.O.

Provider Business Mailing Address
First Line	:	1120 NW 14 ST
Second Line	:	SUITE 955
City	:	MIAMI
State	:	FL
Zip	:	33136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7207 GOLDEN WINGS RD STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-3324
Country	:	US
Telephone Number	:	904-389-1010
Fax Number	:	904-389-1082

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	07/12/2023

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