Provider Demographics
NPI:1386266955
Name:JEAN BAPTISTE, LANDIE (OD)
Entity type:Individual
Prefix:
First Name:LANDIE
Middle Name:
Last Name:JEAN BAPTISTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7571 SAND LAKE POINTE LOOP APT 205
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7237
Mailing Address - Country:US
Mailing Address - Phone:407-591-6627
Mailing Address - Fax:
Practice Address - Street 1:7459 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6508
Practice Address - Country:US
Practice Address - Phone:407-204-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-17
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC005815152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist