Provider Demographics
NPI:1942547351
Name:MY TIME, LLC
Entity Type:Organization
Organization Name:MY TIME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALKENBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:305-632-3359
Mailing Address - Street 1:701 BRICKELL KEY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2674
Mailing Address - Country:US
Mailing Address - Phone:305-632-3359
Mailing Address - Fax:
Practice Address - Street 1:701 BRICKELL KEY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2674
Practice Address - Country:US
Practice Address - Phone:305-632-3359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13372225X00000X
FLOT13152225X00000X
FLSA10156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty