Provider Demographics
NPI:1366485799
Name:HOFFMAN, BENJAMIN R (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 LEAFY WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6438
Mailing Address - Country:US
Mailing Address - Phone:954-531-5360
Mailing Address - Fax:305-774-9121
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2049
Practice Address - Country:US
Practice Address - Phone:954-531-5360
Practice Address - Fax:305-774-9131
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME872932085R0202X
MDD00683562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA210902OtherJOHNS HOPKINS
FL274693000Medicaid
PA245132OtherUNISON-WMG
MD919374OtherCAREFIRST MD BCBS
PA50078859OtherCAPITAL BLUE CROSS-WMG
FL274693000Medicaid
PA126844FLTMedicare PIN
MD919374OtherCAREFIRST MD BCBS