Provider Demographics
NPI:1730959065
Name:CAL, STEPHANIE (PHARMD, BSN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CAL
Suffix:
Gender:F
Credentials:PHARMD, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16690 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1002
Mailing Address - Country:US
Mailing Address - Phone:305-408-7956
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:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9660989163W00000X
FLPS66327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163W00000XNursing Service ProvidersRegistered Nurse