Healthcare Provider Details

I. General information

NPI: 1689486466
Provider Name (Legal Business Name): ROBERT ARTHUR HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 SE 120TH ST
BELLEVIEW FL
34420-4958
US

IV. Provider business mailing address

4720 SE 120TH ST
BELLEVIEW FL
34420-4958
US

V. Phone/Fax

Practice location:
  • Phone: 352-322-3159
  • Fax:
Mailing address:
  • Phone: 352-322-3159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: