Healthcare Provider Details

I. General information

NPI: 1114714433
Provider Name (Legal Business Name): ANETT CHERKASSKY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S UNIVERSITY DR STE C
PLANTATION FL
33324-3329
US

IV. Provider business mailing address

130 S UNIVERSITY DR STE C
PLANTATION FL
33324-3329
US

V. Phone/Fax

Practice location:
  • Phone: 954-634-7966
  • Fax:
Mailing address:
  • Phone: 954-634-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11039026
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: