Healthcare Provider Details

I. General information

NPI: 1154471977
Provider Name (Legal Business Name): JOSHUA A. GOTTSCHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 DANIELS RD STE 150
WINTER GARDEN FL
34787-5785
US

IV. Provider business mailing address

2660 W FAIRBANKS AVE
WINTER PARK FL
32789-3385
US

V. Phone/Fax

Practice location:
  • Phone: 407-253-1000
  • Fax: 407-253-1010
Mailing address:
  • Phone: 407-898-2767
  • Fax: 407-898-9443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA92285
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberME96710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: