Healthcare Provider Details
I. General information
NPI: 1699904946
Provider Name (Legal Business Name): ROBERT ALFRED HOFFERT O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/08/2009
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43309 US HIGHWAY 19 N
TARPON SPRINGS FL
34689-6221
US
IV. Provider business mailing address
43309 US HIGHWAY 19 N
TARPON SPRINGS FL
34689-6221
US
V. Phone/Fax
- Phone: 727-938-2020
- Fax: 727-938-5606
- Phone: 727-938-2020
- Fax: 727-938-5606
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | OPC4671 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: