Healthcare Provider Details

I. General information

NPI: 1326979568
Provider Name (Legal Business Name): JANELLE GONZALEZ BCHHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S CHARLES RICHARD BEALL BLVD STE 101
DEBARY FL
32713-3719
US

IV. Provider business mailing address

1001 OHANLON CT
OVIEDO FL
32765-5907
US

V. Phone/Fax

Practice location:
  • Phone: 407-404-0635
  • Fax:
Mailing address:
  • Phone: 407-404-0635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: