MEDICARE: JESSICA MAY GONZALEZ

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	363LF0000X	Family Nurse Practitioner	APRN11031576	FL

General Provider Information

NPI Number	:	1659125979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MAY GONZALEZ

Provider Business Mailing Address
First Line	:	PO BOX 935921
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-5921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 WATERMAN WAY
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-5229
Country	:	US
Telephone Number	:	352-742-0054
Fax Number	:	352-742-2103

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

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	06/01/2026

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Directions to “ JESSICA MAY GONZALEZ ” Practice Location

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