Provider Demographics
NPI:1093199366
Name:STREETS, COLE RAMSEY (DC)
Entity Type:Individual
Prefix:DR
First Name:COLE
Middle Name:RAMSEY
Last Name:STREETS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19010 PERSIMMON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:FL
Mailing Address - Zip Code:33920-3436
Mailing Address - Country:US
Mailing Address - Phone:239-691-5100
Mailing Address - Fax:
Practice Address - Street 1:4975 ROYAL GULF CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-7006
Practice Address - Country:US
Practice Address - Phone:239-935-7876
Practice Address - Fax:239-935-7855
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor