Healthcare Provider Details

I. General information

NPI: 1366485799
Provider Name (Legal Business Name): BENJAMIN R HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 PONCE DE LEON BLVD
CORAL GABLES FL
33134-2049
US

IV. Provider business mailing address

3908 LEAFY WAY
MIAMI FL
33133-6438
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-5360
  • Fax: 305-774-9131
Mailing address:
  • Phone: 954-531-5360
  • Fax: 305-774-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME87293
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0068356
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: