Provider Demographics
NPI:1558957100
Name:TIME, SHAMEKA YVONNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHAMEKA
Middle Name:YVONNE
Last Name:TIME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6137 SW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3907
Mailing Address - Country:US
Mailing Address - Phone:786-474-7869
Mailing Address - Fax:
Practice Address - Street 1:12401 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2900
Practice Address - Country:US
Practice Address - Phone:954-538-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9510631163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse