Provider Demographics
NPI:1942301700
Name:LAMOUNETTE, ROBERT GEORGES (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGES
Last Name:LAMOUNETTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 HYDE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2839
Mailing Address - Country:US
Mailing Address - Phone:904-783-3700
Mailing Address - Fax:904-695-2579
Practice Address - Street 1:6671 HYDE GROVE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2839
Practice Address - Country:US
Practice Address - Phone:904-783-3700
Practice Address - Fax:904-695-2579
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381560900Medicaid
T93987Medicare UPIN
FL381560900Medicaid