Healthcare Provider Details

I. General information

NPI: 1619912557
Provider Name (Legal Business Name): INFECTIOUS DISEASE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 VIRGINIA ST 4TH FLOOR
DUNEDIN FL
34698
US

IV. Provider business mailing address

P.O. BOX 2216
DUNEDIN FL
34697
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-6932
  • Fax: 727-734-4516
Mailing address:
  • Phone: 727-734-6932
  • Fax: 727-734-4516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS HOFFMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 727-734-6932