Provider Demographics
NPI:1194114298
Name:FUSSION THERAPY ,INC
Entity type:Organization
Organization Name:FUSSION THERAPY ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA YEPES
Authorized Official - Middle Name:R
Authorized Official - Last Name:YEPES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, SLP
Authorized Official - Phone:954-793-0775
Mailing Address - Street 1:8040 NW 95TH ST STE 337
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2361
Mailing Address - Country:US
Mailing Address - Phone:954-793-0775
Mailing Address - Fax:786-360-0030
Practice Address - Street 1:8040 NW 95TH ST STE 337
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2361
Practice Address - Country:US
Practice Address - Phone:954-793-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2025-11-18
Deactivation Date:2024-11-15
Deactivation Code:
Reactivation Date:2025-01-31
Provider Licenses
StateLicense IDTaxonomies
261QM3000X, 343900000X, 221700000X, 171W00000X, 225A00000X
FLSA12791235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day CareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006782300Medicaid
FL1194114298Medicaid
FL126277800Medicaid