Healthcare Provider Details

I. General information

NPI: 1245119155
Provider Name (Legal Business Name): LAURA HOFSTAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 S FEDERAL HWY UNIT 311
BOYNTON BEACH FL
33435-6066
US

IV. Provider business mailing address

1331 S FEDERAL HWY UNIT 311
BOYNTON BEACH FL
33435-6066
US

V. Phone/Fax

Practice location:
  • Phone: 214-226-3623
  • Fax:
Mailing address:
  • Phone: 214-226-3623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9681931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: