Provider Demographics
NPI:1518697309
Name:HOFFMANN, INGRID CORINA
Entity Type:Individual
Prefix:MS
First Name:INGRID
Middle Name:CORINA
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CAPRON ASH LOOP
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3705
Mailing Address - Country:US
Mailing Address - Phone:407-733-0354
Mailing Address - Fax:
Practice Address - Street 1:515 SEMORAN BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5341
Practice Address - Country:US
Practice Address - Phone:321-972-8458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH27316124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist