Individual
DR. BLAKE MIRELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MSC
Contact information
Practice address
2501 N ORANGE AVE STE 235, ORLANDO, FL 32804-4659
(407) 576-8068
Mailing address
6903 ALPERT DR, ORLANDO, FL 32810-3603
(915) 479-2167
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
43612
FL
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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