MEDICARE: DR. JAIME C GONZALEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME49457	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	800073255	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	02718	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316936461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIME C GONZALEZ MD

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 303
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	321-332-6947
Fax Number	:	407-286-4515

Provider Business Practice Location Address
First Line	:	265 W HWY 50
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3027
Country	:	US
Telephone Number	:	352-394-5535
Fax Number	:	352-394-5810

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	02/12/2026

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