Provider Demographics
NPI:1598256406
Name:TIME 2 UNWIND SPA, LLC
Entity Type:Organization
Organization Name:TIME 2 UNWIND SPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:BURGETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:407-375-3559
Mailing Address - Street 1:565 SILVER SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5926
Mailing Address - Country:US
Mailing Address - Phone:407-375-3559
Mailing Address - Fax:
Practice Address - Street 1:1858 N ALAFAYA TRL STE 209
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4754
Practice Address - Country:US
Practice Address - Phone:407-375-3559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center