Provider Demographics
NPI:1952718439
Name:DR. AMY L. HOFFMAN, PSY. D.
Entity type:Organization
Organization Name:DR. AMY L. HOFFMAN, PSY. D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:407-622-0825
Mailing Address - Street 1:1215 LOUISIANA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2344
Mailing Address - Country:US
Mailing Address - Phone:407-622-0825
Mailing Address - Fax:407-622-0826
Practice Address - Street 1:1215 LOUISIANA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2344
Practice Address - Country:US
Practice Address - Phone:407-622-0825
Practice Address - Fax:407-622-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7761103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000559900Medicaid