Healthcare Provider Details

I. General information

NPI: 1609701085
Provider Name (Legal Business Name): MY TIME MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 NW 35TH AVE
LAUDERDALE LAKES FL
33311-1107
US

IV. Provider business mailing address

3413 GALT OCEAN DR
FORT LAUDERDALE FL
33308-7003
US

V. Phone/Fax

Practice location:
  • Phone: 844-996-9362
  • Fax:
Mailing address:
  • Phone: 844-996-9362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BASEEMA HASSEN
Title or Position: OWNER
Credential:
Phone: 844-996-9362