Healthcare Provider Details

I. General information

NPI: 1285598680
Provider Name (Legal Business Name): ANASTASIIA GRYBOVA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7369 SHERIDAN ST STE 203
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7369 SHERIDAN ST STE 203
HOLLYWOOD FL
33024-2776
US

V. Phone/Fax

Practice location:
  • Phone: 954-983-5330
  • Fax: 954-983-5086
Mailing address:
  • Phone: 954-983-5330
  • Fax: 954-983-5086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11043585
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: