Provider Demographics
NPI:1780893032
Name:HOFFA HEATHCARE INC.
Entity type:Organization
Organization Name:HOFFA HEATHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCDO
Authorized Official - Phone:787-724-6565
Mailing Address - Street 1:PO BOX 12330
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-8330
Mailing Address - Country:US
Mailing Address - Phone:787-724-6565
Mailing Address - Fax:787-721-5028
Practice Address - Street 1:150 AVE DE DIEGO
Practice Address - Street 2:SAN JUAN HEATHCENTRE BLDG. SUITE 507
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2300
Practice Address - Country:US
Practice Address - Phone:787-724-6565
Practice Address - Fax:787-721-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR121762305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR121762OtherSERVICE CORPORATION