Healthcare Provider Details

I. General information

NPI: 1568406734
Provider Name (Legal Business Name): NANNETTE BARBARA HOFFMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 NW 83RD ST SENIOR HEALTHCARE CENTER
GAINESVILLE FL
32606-5603
US

IV. Provider business mailing address

3720 NW 83RD ST SENIOR HEALTHCARE CENTER
GAINESVILLE FL
32606-5603
US

V. Phone/Fax

Practice location:
  • Phone: 352-336-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME40556
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number40556
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: