MEDICARE: ANASTASIIA GRYBOVA APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11043585	FL

General Provider Information

NPI Number	:	1285598680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIIA GRYBOVA APRN

Provider Business Mailing Address
First Line	:	7369 SHERIDAN ST STE 203
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2776
Country	:	US
Telephone Number	:	954-983-5330
Fax Number	:	954-983-5086

Provider Business Practice Location Address
First Line	:	7369 SHERIDAN ST STE 203
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2776
Country	:	US
Telephone Number	:	954-983-5330
Fax Number	:	954-983-5086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	03/11/2026

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