Provider Demographics
NPI:1265025183
Name:GONZALEZ, JOSHUA ZEUS (APRN)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ZEUS
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12025 TREVALLY LOOP APT 301
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-0056
Mailing Address - Country:US
Mailing Address - Phone:352-835-8769
Mailing Address - Fax:
Practice Address - Street 1:3543 LITTLE RD STE A
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1814
Practice Address - Country:US
Practice Address - Phone:352-835-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011574363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology