Healthcare Provider Details

I. General information

NPI: 1598607897
Provider Name (Legal Business Name): JEAN GONZALEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 EDEN PARK RD
ALTAMONTE SPRINGS FL
32714-1230
US

IV. Provider business mailing address

498 EDEN PARK RD
ALTAMONTE SPRINGS FL
32714-1230
US

V. Phone/Fax

Practice location:
  • Phone: 407-383-5573
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11046561
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: