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NPI Code Detail

MEDICARE: FUSION MEDICAL CENTER, INC.

MEDICARE: FUSION MEDICAL CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/CenterFL

General Provider Information

NPI Number : 1205275666
Entity Type Code : Organization
Provider Name (Legal Business Name) : FUSION MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 1936 MARTIN LUTHER KING BLVD
Second Line : SUITE 202
City : TAMPA
State : FL
Zip : 33607
Country : US
Telephone Number : 813-408-8563
Fax Number : 813-408-8564
Provider Business Practice Location Address
First Line : 1936 MARTIN LUTHER KING BLVD
Second Line : SUITE 202
City : TAMPA
State : FL
Zip : 33607
Country : US
Telephone Number : 813-408-8563
Fax Number : 813-408-8564
Authorized Official
Title or Position : PRESIDENT
Name : JUNIOR YERO
Credential :
Telephone Number : 813-408-8563
Provider Enumeration Date : 06/19/2013
Last Update Date : 06/19/2013

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Directions to “FUSION MEDICAL CENTER, INC. ” Practice Location

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