Provider Demographics
NPI:1669141727
Name:FUSION MEDICAL & RESEARCH CLINIC LLC
Entity type:Organization
Organization Name:FUSION MEDICAL & RESEARCH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARFRELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-427-7059
Mailing Address - Street 1:9350 SUNSET DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3241
Mailing Address - Country:US
Mailing Address - Phone:786-427-7059
Mailing Address - Fax:
Practice Address - Street 1:9350 SUNSET DR STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3241
Practice Address - Country:US
Practice Address - Phone:786-427-7059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)