Provider Demographics
NPI:1225550494
Name:FUSION MEDICAL CENTER INC
Entity Type:Organization
Organization Name:FUSION MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-516-6931
Mailing Address - Street 1:900 W 49TH ST STE 326
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3435
Mailing Address - Country:US
Mailing Address - Phone:786-516-6931
Mailing Address - Fax:786-542-6567
Practice Address - Street 1:900 W 49TH ST STE 326
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3435
Practice Address - Country:US
Practice Address - Phone:786-516-6931
Practice Address - Fax:786-542-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty