Provider Demographics
NPI:1376526202
Name:COLE, PAULINE MARIE (NP)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6077 BAY ISLES DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4110
Mailing Address - Country:US
Mailing Address - Phone:716-812-7957
Mailing Address - Fax:
Practice Address - Street 1:3651 FAU BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6489
Practice Address - Country:US
Practice Address - Phone:561-409-1767
Practice Address - Fax:561-334-2737
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301257363LA2200X
FL9202182363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01972861Medicaid