Provider Demographics
NPI:1730959065
Name:CAL, STEPHANIE (PHARMD, FNP-BC, BSN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CAL
Suffix:
Gender:F
Credentials:PHARMD, FNP-BC, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 SW 120TH ST STE 113
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-9116
Mailing Address - Country:US
Mailing Address - Phone:305-971-1210
Mailing Address - Fax:
Practice Address - Street 1:16690 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1002
Practice Address - Country:US
Practice Address - Phone:305-408-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9660989163W00000X
FLAPRN11042162363LF0000X
FLPS66327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No183500000XPharmacy Service ProvidersPharmacist