LARRY JACKSON LANDRY (NPI# 1134194608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134194608 |
| Entity Type | Individual |
| Full Name | LARRY JACKSON LANDRY |
| Credential | MD |
| Practice Address |
2200 W Eau Gallie Blvd Suite 202a Melbourne FL 32935-3166 |
| Mailing Address |
240 N Wickham Rd Ste 104 Melbourne FL 32935-8663 |
| Practice Telephone | 3212531992 |
| Practice Fax Number | 3212531844 |
| Mailing Telephone | 3212531992 |
| Mailing Fax Number | 3212531844 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2016-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME95172 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 274787100 | 05 | |
| FL | CIGNA | 2836813001 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 37428 | 01 |
| FL | AETNA | 1226087 | 01 |
| FL | WELLCARE | 325257 | 01 |
| FL | AETNA | 557262 | 01 |
| FL | RAILROAD MEDICARE | P00334279 | 01 |
| Street Address |
2200 W EAU GALLIE BLVD SUITE 202A |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023012820 | Victor Manuel Alvarez | Obstetrics & Gynecology | 2200 W Eau Gallie Blvd, Ste 202-a, Melbourne, FL 32935-3165 | 2005-06-09 |
| 1083990402 | Cristina Cantees | Nurse Practitioner | 2200 W Eau Gallie Blvd, Suite 202-a, Melbourne, FL 32935-3165 | 2011-10-31 |
| 1205078342 | Medical Associates of Brevard LLC | Clinic/Center | 2200 W Eau Gallie Blvd, Suite 202c, Melbourne, FL 32935-3165 | 2009-04-06 |
| 1720109598 | Rakesh Natverlal Patel | Internal Medicine | 2200 W Eau Gallie Blvd, Suite 200, Melbourne, FL 32935-3165 | 2007-04-02 |
| 1518026137 | Jagdeep Chhindra | Internal Medicine | 2200 W Eau Gallie Blvd, Suite 200, Melbourne, FL 32935-3165 | 2006-12-08 |
| 1982791984 | Binod Kumar Singh | Internal Medicine | 2200 W Eau Gallie Blvd, Suite # 202-a, Melbourne, FL 32935-3165 | 2006-10-10 |
| 1720098882 | Medical Associates of Brevard LLC | Clinic/Center | 2200 W Eau Gallie Blvd, Suite 200, Melbourne, FL 32935-3165 | 2006-08-09 |
| 1518977131 | Medical Associates of Brevard LLC | Clinic/Center | 2200 W Eau Gallie Blvd, Suite 202b, Melbourne, FL 32935-3165 | 2006-08-08 |
| 1861400103 | Medical Associates of Brevard LLC | Clinic/Center | 2200 W Eau Gallie Blvd, Suite 200, Melbourne, FL 32935 | 2006-08-03 |
| 1275594897 | Anthony H Tran | Internal Medicine | 2200 W Eau Gallie Blvd, Suite 202c, Melbourne, FL 32935-3166 | 2006-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1144477795 | Matei T Andreoiu | Urology | 8725 N Wickham Rd Ste 202, Melbourne, FL 32940-2240 | 2008-08-26 |
| 1881869089 | Bassem M Eldaif | Urology | 6032 Farcenda Pl Ste 102, Melbourne, FL 32940 | 2008-04-28 |
| 1346462710 | Om Urology LLC | Urology | 3160 W Eau Gallie Blvd Ste 101, Melbourne, FL 32934-7204 | 2007-05-03 |
| 1598718504 | Noone Urology | Urology | 2202 S Babcock St, Suite 101, Melbourne, FL 32901-5370 | 2006-05-19 |
| 1649256256 | Peter P Zabinski | Urology | 1405 Pine St, Melbourne, FL 32901-3118 | 2005-12-16 |
| 1609867696 | Boris Havkin | Urology | 3021 W Eau Gallie Blvd, Melbourne, FL 32934-7005 | 2005-10-31 |
| 1245231190 | Douglas P Sorensen | Urology | 200 Michigan Ave, Melbourne, FL 32901-3100 | 2005-08-02 |
| 1750882247 | Bassem Eldaif Md Pa | Urology | 6032 Farcenda Pl Ste 102, Melbourne, FL 32940 | 2018-02-21 |
| 1679934996 | Boris Havkin Pllc | Urology | 3021 W Eau Gallie Blvd, Suite 103, Melbourne, FL 32934-7005 | 2016-03-14 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.