Provider Demographics
NPI:1528021037
Name:HOFFMAN, JEFFREY STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:STEPHEN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6542 NEWPORT LAKE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496
Mailing Address - Country:US
Mailing Address - Phone:561-241-7670
Mailing Address - Fax:561-733-4448
Practice Address - Street 1:3491 WOOLBRIGHT RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436
Practice Address - Country:US
Practice Address - Phone:561-736-0000
Practice Address - Fax:561-733-4442
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381165700Medicaid
70509Medicare ID - Type Unspecified
FL381165700Medicaid