Provider Demographics
NPI:1528162666
Name:HOFFMAN, DEBRA (DC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11802 NORTH 56TH STREET
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617
Mailing Address - Country:US
Mailing Address - Phone:813-985-1322
Mailing Address - Fax:813-985-5967
Practice Address - Street 1:11802 NORTH 56TH STREET
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617
Practice Address - Country:US
Practice Address - Phone:813-985-1322
Practice Address - Fax:813-985-5967
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88829OtherBLUE CROSS BLUE SHIELD
T55985Medicare UPIN
FL88829Medicare ID - Type Unspecified