Provider Demographics
NPI:1114241783
Name:HOFFMAN CHIROPRACTIC CLINIC, P.A.
Entity Type:Organization
Organization Name:HOFFMAN CHIROPRACTIC CLINIC, P.A.
Other - Org Name:CHIROPRACTIC NATURAL MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-453-2844
Mailing Address - Street 1:950 N COURTENAY PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4501
Mailing Address - Country:US
Mailing Address - Phone:321-453-2844
Mailing Address - Fax:
Practice Address - Street 1:950 N COURTENAY PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4501
Practice Address - Country:US
Practice Address - Phone:321-453-2844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381818700Medicaid
FL381818700Medicaid
FL22006Medicare PIN