Healthcare Provider Details

I. General information

NPI: 1871579649
Provider Name (Legal Business Name): STANLEY D HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 OFFICE PARK DR STE 6
PALM COAST FL
32137-3830
US

IV. Provider business mailing address

7652 ASHLEY PARK CT STE 305
ORLANDO FL
32835-6199
US

V. Phone/Fax

Practice location:
  • Phone: 407-299-7333
  • Fax:
Mailing address:
  • Phone: 407-299-7333
  • Fax: 407-293-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number200000825
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME0117213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: