Provider Demographics
NPI:1245730373
Name:HOFFMAN, MORGAN LEIGH (DPT, ATC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEIGH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 DR MARTIN LUTHER KING JR ST N APT 2602
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1604
Mailing Address - Country:US
Mailing Address - Phone:814-706-8955
Mailing Address - Fax:
Practice Address - Street 1:13817 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9655
Practice Address - Country:US
Practice Address - Phone:813-849-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL39149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program