MEDICARE: MS. DEBBIE KIM HOEFFNER LCSW

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	1041C0700X	Clinical Social Worker	SW 8727	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SW 8727	OTHER		FLORIDA LICENSE

General Provider Information

NPI Number	:	1831371145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBBIE KIM HOEFFNER LCSW

Provider Business Mailing Address
First Line	:	776 W MIDWAY RD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-4203
Country	:	US
Telephone Number	:	772-323-4134
Fax Number	:

Provider Business Practice Location Address
First Line	:	776 W MIDWAY RD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-4203
Country	:	US
Telephone Number	:	772-323-4134
Fax Number	:

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

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	12/17/2013

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