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General NPI Number Information
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NPI Number | 1861383804
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Entity Type | Individual
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Provider Name | ODETTE HOFFMANN GUADALUPE
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 2113 RUBY RED BLVD STE D
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City | CLERMONT
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State | FL
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Zip | 34714-6115
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Country | US
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Telephone | 352-394-0573
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Fax |
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Provider Business Mailing Address
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Address Line | 600 RIVER BIRCH CT APT 1223
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City | CLERMONT
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State | FL
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Zip | 34711-5137
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Country | US
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Telephone | 787-800-9928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH26975
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License Number State | FL
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