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General NPI Number Information
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NPI Number | 1750450334
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Entity Type | Individual
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Provider Name | LISA MARIE KEARNS MS PT
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 1200 ANASTASIA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-6339
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Country | US
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Telephone | 305-381-6223
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Fax | 305-381-6294
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Provider Business Mailing Address
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Address Line | 1172 S DIXIE HWY #548
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City | CORAL GABLES
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State | FL
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Zip | 33146-2918
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Country | US
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Telephone | 305-381-6223
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Fax | 305-381-6294
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT7291
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License Number State | FL
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