Healthcare Provider Details

I. General information

NPI: 1982539805
Provider Name (Legal Business Name): UNISON SPA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S APOLLO BLVD STE 3
MELBOURNE FL
32901-4615
US

IV. Provider business mailing address

1601 S APOLLO BLVD STE 3
MELBOURNE FL
32901-4615
US

V. Phone/Fax

Practice location:
  • Phone: 321-357-5577
  • Fax:
Mailing address:
  • Phone: 321-327-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MAURICE WILSON
Title or Position: OWNER
Credential: LMT
Phone: 321-327-5577