Provider Demographics
NPI:1053417428
Name:COLE, PERRY J (MD)
Entity type:Individual
Prefix:MR
First Name:PERRY
Middle Name:J
Last Name:COLE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3100 UNIVERSITY BLVD S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2742
Mailing Address - Country:US
Mailing Address - Phone:904-274-8813
Mailing Address - Fax:904-503-4465
Practice Address - Street 1:3100 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 300
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2742
Practice Address - Country:US
Practice Address - Phone:904-274-8813
Practice Address - Fax:904-503-4465
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-05-07
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Provider Licenses
StateLicense IDTaxonomies
FLME83999207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271976200Medicaid
FL62728OtherBCBS
FL614424600OtherOWCP - FECA
FL614424600OtherOWCP - FECA
FL271976200Medicaid