Healthcare Provider Details

I. General information

NPI: 1134412430
Provider Name (Legal Business Name): RACHEL ELISABETH HOFER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 NW 53RD AVE
GAINESVILLE FL
32653-4857
US

IV. Provider business mailing address

1301 SW 76TH DR
GAINESVILLE FL
32607-3381
US

V. Phone/Fax

Practice location:
  • Phone: 352-577-8431
  • Fax:
Mailing address:
  • Phone: 352-577-8431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH 8985
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: