Provider Demographics
NPI:1265764377
Name:COLE, EDWARD LES III (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:LES
Last Name:COLE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704
Mailing Address - Country:US
Mailing Address - Phone:727-202-6807
Mailing Address - Fax:727-202-6896
Practice Address - Street 1:2100 DR MARTIN LUTHER KING JR ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704
Practice Address - Country:US
Practice Address - Phone:727-202-6807
Practice Address - Fax:727-498-6642
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2017-10-26
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Provider Licenses
StateLicense IDTaxonomies
FLME43905208D00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice