Healthcare Provider Details

I. General information

NPI: 1003696790
Provider Name (Legal Business Name): CASSANDRA HOFFMAN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CLEARWATER LARGO RD N
LARGO FL
33770-4131
US

IV. Provider business mailing address

3724 15TH TER SE
LARGO FL
33771-4056
US

V. Phone/Fax

Practice location:
  • Phone: 727-518-6444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11028952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: