MEDICARE: JEAN GONZALEZ APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11046561	FL

General Provider Information

NPI Number	:	1598607897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN GONZALEZ APRN

Provider Business Mailing Address
First Line	:	498 EDEN PARK RD
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1230
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	498 EDEN PARK RD
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1230
Country	:	US
Telephone Number	:	407-383-5573
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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