Healthcare Provider Details

I. General information

NPI: 1770745960
Provider Name (Legal Business Name): ROBERT FRANCIS HOFMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2008
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 MAR WALT DR STE 200
FORT WALTON BEACH FL
32547-6639
US

IV. Provider business mailing address

1034 MAR WALT DR UNIT 200
FORT WALTON BEACH FL
32547-6637
US

V. Phone/Fax

Practice location:
  • Phone: 850-862-4001
  • Fax: 850-862-1612
Mailing address:
  • Phone: 813-908-2020
  • Fax: 813-908-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG1918
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME103710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: