Healthcare Provider Details
I. General information
NPI: 1780893032
Provider Name (Legal Business Name): HOFFA HEATHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 AVE DE DIEGO SAN JUAN HEATHCENTRE BLDG. SUITE 507
SAN JUAN PR
00907-2300
US
IV. Provider business mailing address
PO BOX 12330
SAN JUAN PR
00914-8330
US
V. Phone/Fax
- Phone: 787-724-6565
- Fax: 787-721-5028
- Phone: 787-724-6565
- Fax: 787-721-5028
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | 121762 |
| License Number State | PR |
VIII. Authorized Official
Name: MR.
LUIS
FRANCISCO
HERNANDEZ
Title or Position: PRESIDENT
Credential: LCDO.
Phone: 787-724-6565