Healthcare Provider Details

I. General information

NPI: 1477489763
Provider Name (Legal Business Name): ANNA TOKAREVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 WASHINGTON ST STE 103
HOLLYWOOD FL
33021-8283
US

IV. Provider business mailing address

3250 NE 188TH ST APT 901
AVENTURA FL
33180-3365
US

V. Phone/Fax

Practice location:
  • Phone: 305-778-7818
  • Fax:
Mailing address:
  • Phone: 305-607-6070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048156
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: