Organization
DR. LISA PT LLC
Active
Organization
DR. LISA PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA FERNANDEZ (OWNER/MANAGING MEMBER)
(305) 467-9421
Entity
Organization
Contact information
Practice address
1794 ROUND LAKE RD, INTERLOCHEN, MI 49643-8435
(305) 467-9421
(305) 686-2397
Mailing address
1794 ROUND LAKE RD, INTERLOCHEN, MI 49643-8435
(305) 467-9421
(305) 686-2397
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
08/18/2026
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