Provider Demographics
NPI:1124353784
Name:HOFFMAN, BENJAMIN NATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:NATHAN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:STE 204
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463
Mailing Address - Country:US
Mailing Address - Phone:561-966-7707
Mailing Address - Fax:
Practice Address - Street 1:3918 VIA POINCIANA
Practice Address - Street 2:STE 8
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:561-964-3700
Practice Address - Fax:561-641-2484
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104206207R00000X, 207SG0201X, 208000000X
NY251979-1207SG0201X, 208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFX972Medicare PIN