Healthcare Provider Details

I. General information

NPI: 1609453174
Provider Name (Legal Business Name): ADRIANA COLLADA HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

3586 NORTHCLIFFE RD
UNIVERSITY HEIGHTS OH
44118-3667
US

V. Phone/Fax

Practice location:
  • Phone: 305-457-9535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAPP-000449583
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: