Healthcare Provider Details

I. General information

NPI: 1134241540
Provider Name (Legal Business Name): DR KYLE D ABSHIRE & DR JAMES R HOFFMAN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 PARK AVE 100
ORANGE PARK FL
32073-4101
US

IV. Provider business mailing address

905 PARK AVE 100
ORANGE PARK FL
32073-4101
US

V. Phone/Fax

Practice location:
  • Phone: 904-264-1206
  • Fax: 904-264-3685
Mailing address:
  • Phone: 904-264-1206
  • Fax: 904-264-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES ROBERT HOFFMAN
Title or Position: PARTNER
Credential: O.D.
Phone: 904-264-1206