Healthcare Provider Details

I. General information

NPI: 1245920412
Provider Name (Legal Business Name): MELISSA HOFFMANN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13568 NW 1ST LN STE 1
NEWBERRY FL
32669-3698
US

IV. Provider business mailing address

13568 NW 1ST LN STE 1
NEWBERRY FL
32669-3698
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-9448
  • Fax: 352-331-9621
Mailing address:
  • Phone: 352-331-9448
  • Fax: 352-331-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: