Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | OS8697 | FL |
NPI | 1316929771 |
---|---|
Provider Name | William J Cole JR. |
First Address | Sarasota, FL 34233-2550 |
Second Address | Sarasota, FL 34233-2550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 21/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
260848710 | TID (01) | FL |
34004 | BCBS (01) | FL |
BC8861658 | DEA LICENSE # (01) | |
I43415 | (02) | |
P00355672 | MEDICARE RR (01) | FL |