Provider Demographics
NPI:1588260657
Name:COLE, SHARON ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ELIZABETH
Last Name:COLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 MCCULLOUGH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-7226
Mailing Address - Country:US
Mailing Address - Phone:813-764-6935
Mailing Address - Fax:
Practice Address - Street 1:2801 17TH ST UNIT 202
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4939
Practice Address - Country:US
Practice Address - Phone:407-530-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist