MEDICARE: DR. JOEL DAVID GONZALEZ-MENDEZ M.D.

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	208D00000X	General Practice Physician	15596	PR
2	208D00000X	General Practice Physician	ACN790	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1136362	OTHER	FL	CAREPLUS
2	200000039833	OTHER	FL	ULTIMATE HEALTH
3	LX2J49-AE	OTHER	FL	DEVOTED
4	T8F03	OTHER	FL	FLORIDA BLUE
5	P1042908	OTHER	FL	FREEDOM
6	05584642	OTHER	FL	SIMPLY
7	6831972	OTHER	FL	AETNA
8	QMP000004790310	OTHER	FL	CIGNA
9	T8F03	OTHER	FL	FLBLUE
10	P978389	OTHER	FL	OPTIMUM
11	P66439464	OTHER	FL	UHC
12	2938801	OTHER	FL	WEELLCARE
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811910060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL DAVID GONZALEZ-MENDEZ M.D.

Provider Business Mailing Address
First Line	:	6675 WESTWOOD BLVD STE 475
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-6027
Country	:	US
Telephone Number	:	407-845-0330
Fax Number	:

Provider Business Practice Location Address
First Line	:	3372 W SOUTHPORT RD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-2706
Country	:	US
Telephone Number	:	407-933-7900
Fax Number	:	321-437-0072

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	05/31/2023

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