Healthcare Provider Details

I. General information

NPI: 1447241054
Provider Name (Legal Business Name): BRUCE ROLAND HOFFEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W CRYSTAL LAKE ST STE 200
ORLANDO FL
32806-4476
US

IV. Provider business mailing address

25 W CRYSTAL LAKE ST STE 200
ORLANDO FL
32806-4476
US

V. Phone/Fax

Practice location:
  • Phone: 407-254-2500
  • Fax: 407-423-2789
Mailing address:
  • Phone: 407-254-2500
  • Fax: 407-423-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME64419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: