Healthcare Provider Details

I. General information

NPI: 1437745874
Provider Name (Legal Business Name): CARATIVE PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 843-474-5578
  • Fax: 843-790-1871
Mailing address:
  • Phone: 843-474-5578
  • Fax: 843-790-1857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ASHLEY CYRONAK
Title or Position: OWNER
Credential: MSN, APRN, FNP-C, PM
Phone: 843-474-5578