Provider Demographics
NPI:1891299897
Name:CARDONA, STEPHANIE (DO)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST STE 204B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:305-928-7249
Mailing Address - Fax:305-630-3632
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2197
Practice Address - Country:US
Practice Address - Phone:305-928-7249
Practice Address - Fax:305-630-3632
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS20019208D00000X, 207RC0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program