Provider Demographics
NPI:1033275417
Name:HODER, ERIC M (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:HODER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10078 NW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7035
Mailing Address - Country:US
Mailing Address - Phone:954-472-7975
Mailing Address - Fax:954-472-7941
Practice Address - Street 1:10078 NW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7035
Practice Address - Country:US
Practice Address - Phone:954-472-7975
Practice Address - Fax:954-472-7941
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0008593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64021Medicare ID - Type Unspecified