Stephanie Phan, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS17951 Issued in FL

Practice address

410 Lionel Way FL 3
Davenport, FL 33837-7809

Phone

(863) 293-1191

Fax

(863) 837-5333

NPI assigned

Jun 29, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.phan.p1@direct.bondclinicpa.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bond Clinic PA

  • Internal Medicine Physician
  • Winter Haven, FL
  • NPI 1881639193

  Pediatrics

  Medicare reassignment NPD
• Bond Clinic PA

  • Internal Medicine Physician
  • Winter Haven, FL
  • NPI 1992565766

  Pediatrics

  NPD
• Bond Urgent Care LLC

  • Urgent Care Clinic/Center
  • Winter Haven, FL
  • NPI 1235641739
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1639664717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803094",
            "telephone_number": "863-293-1191",
            "fax_number": "863-837-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY FL 3",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809",
            "telephone_number": "863-293-1191",
            "fax_number": "863-837-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6484 Fort Caroline Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322772042",
            "country_code": "US",
            "telephone_number": "904-659-4735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "STEPHANIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS17951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Peterside
• Scott William Peterson, MD
• Michael Petit-Homme
• Jeffrey Ryan Petrie, MD
• Alysha N Petroff, APRN
• Chantiya R Pharham
• Deborah A Phillips, ARNP
• Sarah Philp, PHARMD
• Physiotherapy Works, LLC
• Nelson Miguel Pichardo, M.D.

• Pediatrics Physician in Davenport, FL
• Providers in Davenport, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.