Healthcare Provider Details

I. General information

NPI: 1952279481
Provider Name (Legal Business Name): STEPHANIE CANALS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W DR MARTIN LUTHER KING JR BLVD
TAMPA FL
33607-6307
US

IV. Provider business mailing address

964 SUNLIT CORAL ST
RUSKIN FL
33570-8119
US

V. Phone/Fax

Practice location:
  • Phone: 813-554-8500
  • Fax:
Mailing address:
  • Phone: 786-285-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number11042113
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: