Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1639664717 Individual Practitioner Female Practitioner

Dr. Stephanie Phan , DO

Pediatrics • Davenport, FL

Professional Overview & Biography Verified Profile Summary

Dr. Stephanie Phan, DO is a registered healthcare professional specializing in Pediatrics in Davenport, FL. Practice services are available at 410 LIONEL WAY FL 3 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

410 Lionel Way Fl 3

Davenport, FL 338377809

Telephone 8632931191
Fax 8638375333
Associated Practice Facility / Clinic
🏢 Bond Clinic Pa Facility NPI 1881639193

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Davenport, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Davenport, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-03-02
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL OS17951

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

6484 Fort Caroline Rd

Jacksonville, FL 322772042

Phone: 9046594735

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Logan Hanson , DO

Orthopaedic Surgery

NPI 1013350032

Doctor of Osteopathic Medicine (D.O.)

Dr. Robert Lerner , MD

Orthopaedic Surgery

NPI 1023015096

Doctor of Medicine (M.D.)

Candy Bridges , APRN

Nurse Practitioner - Family

NPI 1023573961

Advanced Practice Registered Nurse

Dr. Alan Sallman , MD

Internal Medicine - Nephrology

NPI 1033117486

Doctor of Medicine (M.D.)

NPI 1033474838

Doctor of Medicine (M.D.)

Dr. Sammy Moussly , MD

Internal Medicine - Hematology & Oncology

NPI 1033640545

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location September 23, 2024

Registered at 410 LIONEL WAY FL 3, DAVENPORT, FL 338377809 (Tel: 8632931191)

📍
Updated Business Mailing Address September 23, 2024

Registered at 500 E CENTRAL AVE, WINTER HAVEN, FL 338803094 (Tel: 8632931191)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2024

Pediatrics (License #OS17951 in FL)

NPI Profile Active June 29, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location June 29, 2018

Registered at 92 W MILLER ST, ORLANDO, FL 328062032 (Tel: 4076496876)

📍
Updated Business Mailing Address June 29, 2018

Registered at 86 W UNDERWOOD ST STE 202, ORLANDO, FL 328061110 (Tel: 4076496876)

👤
Provider Name / Credentials Updated June 29, 2018

Recorded as STEPHANIE PHAN, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2018

Student in an Organized Health Care Education/Training Program (License #UO6079 in FL)

🟢
Initial NPI Registration & Enumeration June 29, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639664717
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 29, 2018
Last Update: March 02, 2026
Sole Proprietor: Yes

Mailing Address

500 E Central Ave

Winter Haven, FL 338803094

Phone: 8632931191

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.