Healthcare Provider Details

I. General information

NPI: 1942301700
Provider Name (Legal Business Name): ROBERT GEORGES LAMOUNETTE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6671 HYDE GROVE AVE
JACKSONVILLE FL
32210-2839
US

IV. Provider business mailing address

6671 HYDE GROVE AVE
JACKSONVILLE FL
32210-2839
US

V. Phone/Fax

Practice location:
  • Phone: 904-783-3700
  • Fax: 904-695-2579
Mailing address:
  • Phone: 904-783-3700
  • Fax: 904-695-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0005338
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: