Healthcare Provider Details

I. General information

NPI: 1972634541
Provider Name (Legal Business Name): JOHN FIELDING HOFFMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 10/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3725 11TH CIR
VERO BEACH FL
32960-4804
US

IV. Provider business mailing address

PO BOX 830674
BIRMINGHAM AL
35283-0674
US

V. Phone/Fax

Practice location:
  • Phone: 772-562-0163
  • Fax:
Mailing address:
  • Phone: 855-666-9508
  • Fax: 772-621-3184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR1277
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01068003
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME109966
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: