Provider Demographics
NPI:1962894378
Name:BLANCHETTE, DENNIS CARL (DO)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CARL
Last Name:BLANCHETTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1720 S ORANGE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2945
Mailing Address - Country:US
Mailing Address - Phone:407-426-9693
Mailing Address - Fax:407-426-9694
Practice Address - Street 1:1720 S ORANGE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2945
Practice Address - Country:US
Practice Address - Phone:407-426-9693
Practice Address - Fax:407-426-9694
Is Sole Proprietor?:No
Enumeration Date:2015-02-22
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS13383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine