Healthcare Provider Details

I. General information

NPI: 1073125787
Provider Name (Legal Business Name): KEITH ANDREW HOFFMAN PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22829 STATE ROAD 54
LAND O LAKES FL
34639-5227
US

IV. Provider business mailing address

22829 STATE ROAD 54
LAND O LAKES FL
34639-5227
US

V. Phone/Fax

Practice location:
  • Phone: 813-949-0464
  • Fax:
Mailing address:
  • Phone: 813-949-0464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS52817
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: