Provider Demographics
NPI:1053642132
Name:BRUCE R HOFFEN MD PA
Entity Type:Organization
Organization Name:BRUCE R HOFFEN MD PA
Other - Org Name:FLORIDA NEUROHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-332-5141
Mailing Address - Street 1:515 W STATE ROAD 434 STE 205
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5138
Mailing Address - Country:US
Mailing Address - Phone:407-332-5141
Mailing Address - Fax:407-332-6819
Practice Address - Street 1:515 W STATE ROAD 434 STE 205
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5138
Practice Address - Country:US
Practice Address - Phone:407-332-5141
Practice Address - Fax:407-332-6819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME644192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty