Healthcare Provider Details

I. General information

NPI: 1942261805
Provider Name (Legal Business Name): THOMAS HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S HARBOR CITY BLVD OSLER MEDICAL
MELBOURNE FL
32901
US

IV. Provider business mailing address

930 S HARBOR CITY BLVD OSLER MEDICAL
MELBOURNE FL
32901
US

V. Phone/Fax

Practice location:
  • Phone: 321-725-5050
  • Fax: 321-725-8739
Mailing address:
  • Phone: 321-725-5050
  • Fax: 321-725-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME39789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: