Healthcare Provider Details

I. General information

NPI: 1730959065
Provider Name (Legal Business Name): STEPHANIE CAL PHARMD, FNP-BC, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CORAL WAY STE 207
CORAL GABLES FL
33134-4924
US

IV. Provider business mailing address

12600 SW 120TH ST STE 113
MIAMI FL
33186-9116
US

V. Phone/Fax

Practice location:
  • Phone: 305-445-2941
  • Fax:
Mailing address:
  • Phone: 305-971-1210
  • Fax: 305-971-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9660989
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11042162
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66327
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: