Provider Demographics
NPI:1316929771
Name:COLE, WILLIAM J JR (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:COLE
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:4071 BEE RIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2550
Mailing Address - Country:US
Mailing Address - Phone:941-371-7171
Mailing Address - Fax:941-371-7474
Practice Address - Street 1:4071 BEE RIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2550
Practice Address - Country:US
Practice Address - Phone:941-371-7171
Practice Address - Fax:941-371-7474
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS86972081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260848710OtherTID
FLP00355672OtherMEDICARE RR
FL34004OtherBCBS
BC8861658OtherDEA LICENSE #
I43415Medicare UPIN