Detournay, Lisa Marie

Detournay, Lisa Marie is an sole proprietor health care provider with primary practice located at 1611 Nw 12Th Ave , Miami FL 33136-1005. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Detournay, Lisa Marie can be contacted via phone (305) 710-1971.

Contact Information

Primary practice address
1611 Nw 12Th Ave Miami FL 33136-1005
Phone: (305) 710-1971
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO1933 Florida

Profile Details

NPI number 1952301426
LBN Legal business name Detournay, Lisa Marie
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2005
Last updated Aug 12th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952301426 NPPES
Florida MEDICAID 029750000

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