Provider Demographics
NPI:1619785227
Name:ESSENCE OF TIME HEALING AND WELLNESS LLC
Entity type:Organization
Organization Name:ESSENCE OF TIME HEALING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAMEKA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:TIME
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-474-4792
Mailing Address - Street 1:6102 HOGAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2234
Mailing Address - Country:US
Mailing Address - Phone:786-474-4792
Mailing Address - Fax:
Practice Address - Street 1:6102 HOGAN CREEK RD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-2234
Practice Address - Country:US
Practice Address - Phone:786-474-7869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-28
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center