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General NPI Number Information
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NPI Number | 1386023463
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Entity Type | Individual
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Provider Name | JONATHAN GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 14011 BEACH BLVD STE 210-220
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City | JACKSONVILLE
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State | FL
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Zip | 32250-1694
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Country | US
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Telephone | 904-367-2277
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Fax | 904-421-3788
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 904-745-3618
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Fax | 904-722-4271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.131986
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME134024
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License Number State | FL
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