Healthcare Provider Details

I. General information

NPI: 1619785227
Provider Name (Legal Business Name): ESSENCE OF TIME HEALING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 WILES RD
CORAL SPRINGS FL
33067-2037
US

IV. Provider business mailing address

7630 WILES RD
CORAL SPRINGS FL
33067-2037
US

V. Phone/Fax

Practice location:
  • Phone: 786-474-7869
  • Fax:
Mailing address:
  • Phone: 786-474-4792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS SHAMEKA YVONNE TIME
Title or Position: MANAGER
Credential: ARNP
Phone: 786-474-4792