Healthcare Provider Details

I. General information

NPI: 1194114298
Provider Name (Legal Business Name): FUSSION THERAPY ,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date: 11/15/2024
Reactivation Date: 01/31/2025

III. Provider practice location address

8040 NW 95TH ST STE 337
HIALEAH GARDENS FL
33016-2361
US

IV. Provider business mailing address

8040 NW 95TH ST STE 337
HIALEAH GARDENS FL
33016-2361
US

V. Phone/Fax

Practice location:
  • Phone: 954-793-0775
  • Fax:
Mailing address:
  • Phone: 954-793-0775
  • Fax: 786-360-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA12791
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: GLORIA YEPES R YEPES
Title or Position: DIRECTOR/OWNER
Credential: MS., SLP
Phone: 954-793-0775