Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | OS10986 | FL |
NPI | 1154389245 |
---|---|
Provider Name | Dr. Jonathan David Hoffberger |
First Address | Orlando, FL 32886-3407 |
Second Address | Sarasota, FL 34239-2930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 03/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002945800 | (05) | FL |
H82985 | (02) | FL |