Healthcare Provider Details

I. General information

NPI: 1124124607
Provider Name (Legal Business Name): RENEE HOFFINGER R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

4336 NW 27TH DR
GAINESVILLE FL
32605-1643
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-4059
  • Fax:
Mailing address:
  • Phone: 352-374-4478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND0001593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: