Healthcare Provider Details

I. General information

NPI: 1477474724
Provider Name (Legal Business Name): FUSIONMD COSMETIC SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 SW 22ND ST
MIAMI FL
33145-2946
US

IV. Provider business mailing address

1395 SW 22ND ST
MIAMI FL
33145-2946
US

V. Phone/Fax

Practice location:
  • Phone: 305-686-1122
  • Fax: 844-281-4752
Mailing address:
  • Phone: 305-686-1122
  • Fax: 844-281-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA RYAN SCURLOCK
Title or Position: OWNER
Credential: MD
Phone: 305-686-1122