Healthcare Provider Details

I. General information

NPI: 1386671154
Provider Name (Legal Business Name): THOMAS A. HOFFMAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 VIRGINIA ST. 421
DUNEDIN FL
34698
US

IV. Provider business mailing address

P.O. BOX 2216
DUNEDIN FL
34697-2216
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-9267
  • Fax: 727-734-9267
Mailing address:
  • Phone: 727-734-6932
  • Fax: 727-734-4612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME69728
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: