Provider Demographics
NPI:1114543659
Name:HOSFORD, ELAINE FARRAR (PT)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:FARRAR
Last Name:HOSFORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5064 PORTSMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9278
Mailing Address - Country:US
Mailing Address - Phone:352-360-9841
Mailing Address - Fax:
Practice Address - Street 1:4680 BELLWETHER LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34484-2968
Practice Address - Country:US
Practice Address - Phone:352-360-9841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist