Healthcare Provider Details

I. General information

NPI: 1184569717
Provider Name (Legal Business Name): RESTORA CLINICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

13563 NARCOOSSEE RD STE 110
ORLANDO FL
32832-7138
US

IV. Provider business mailing address

6441 S CHICKASAW TRL PMB 324
ORLANDO FL
32829-8366
US

V. Phone/Fax

Practice location:
  • Phone: 407-730-4240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA GOKOOL
Title or Position: MANAGER
Credential: APRN
Phone: 407-409-0787