MEDICARE: DR. JOHN LOUIS HOFFMAN D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	PO 2199	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518965649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LOUIS HOFFMAN D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 4162
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33775-4162
Country	:	US
Telephone Number	:	727-422-7655
Fax Number	:	727-395-0207

Provider Business Practice Location Address
First Line	:	11819 109TH CT
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33778-3656
Country	:	US
Telephone Number	:	727-422-7655
Fax Number	:	727-395-0207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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