Healthcare Provider Details

I. General information

NPI: 1821069626
Provider Name (Legal Business Name): MICHAEL ELLIS HOFFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-3564
  • Fax: 305-243-2009
Mailing address:
  • Phone: 305-243-3564
  • Fax: 305-243-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberG66336
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME63805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: