Healthcare Provider Details

I. General information

NPI: 1790814424
Provider Name (Legal Business Name): IRVING HOFFMAN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2843 ALTERNATE 19
PALM HARBOR FL
34683
US

IV. Provider business mailing address

2843 ALTERNATE 19
PALM HARBOR FL
34683
US

V. Phone/Fax

Practice location:
  • Phone: 727-365-4289
  • Fax: 727-787-2384
Mailing address:
  • Phone: 727-365-4289
  • Fax: 727-787-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberFLMH2193
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: