Individual
BLAKE C. LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
83 W MILLER ST, ORLANDO, FL 32806-2031
(321) 841-5281
(321) 843-2068
Mailing address
83 W MILLER ST, ORLANDO, FL 32806-2031
(321) 841-5281
(321) 843-2068
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
022661
LA
207V00000X
Obstetrics & Gynecology Physician
022661
LA
207V00000X
Obstetrics & Gynecology Physician
Primary
ME174917
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005507718
AETNA
LA
05
—
128831500
—
FL
05
—
1494895
—
LA
01
—
153236130118
HUMANA
LA
01
—
720847461 0009
CIGNA
LA
Enumeration date
06/23/2005
Last updated
10/30/2025
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