Provider Demographics
NPI:1649207093
Name:LAMOURT, MICHELE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:LAMOURT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 WHITFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1529
Mailing Address - Country:US
Mailing Address - Phone:941-544-3553
Mailing Address - Fax:941-927-8731
Practice Address - Street 1:3687 WEBBER ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-4412
Practice Address - Country:US
Practice Address - Phone:941-922-9312
Practice Address - Fax:941-927-8731
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7627111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74824OtherBCBS
FL55814Medicare ID - Type Unspecified
FL55814ZMedicare ID - Type UnspecifiedGROUP NUMBER
FLU74155Medicare UPIN
FLK6579Medicare ID - Type UnspecifiedGROUP NUMBER