Healthcare Provider Details

I. General information

NPI: 1285648428
Provider Name (Legal Business Name): ELIZABETH ANN HODAPP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 17TH AVE
MIAMI FL
33101-6960
US

IV. Provider business mailing address

800 DOUGLAS ROAD SUITE 150
CORAL GABLES FL
33134-2087
US

V. Phone/Fax

Practice location:
  • Phone: 305-326-6031
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-461-0212
  • Fax: 305-461-0208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME37651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: