Provider Demographics
NPI:1396967188
Name:COLE, BARRY HILLARD
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:HILLARD
Last Name:COLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 CARRIAGE GATE DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-9598
Mailing Address - Country:US
Mailing Address - Phone:321-727-1814
Mailing Address - Fax:321-722-9502
Practice Address - Street 1:1340 PALM BAY RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3828
Practice Address - Country:US
Practice Address - Phone:321-725-9770
Practice Address - Fax:321-724-9604
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL2425174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian