Healthcare Provider Details

I. General information

NPI: 1710868328
Provider Name (Legal Business Name): FUSION HEALTH AND WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 GALL BLVD
ZEPHYRHILLS FL
33542-3453
US

IV. Provider business mailing address

5741 GALL BLVD
ZEPHYRHILLS FL
33542-3453
US

V. Phone/Fax

Practice location:
  • Phone: 352-567-9084
  • Fax:
Mailing address:
  • Phone: 352-567-9084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY FERNANDEZ
Title or Position: MEMBER
Credential: DC
Phone: 352-567-9084