Provider Demographics
NPI:1811910060
Name:GONZALEZ-MENDEZ, JOEL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:DAVID
Last Name:GONZALEZ-MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 WESTWOOD BLVD STE 475
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6027
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:
Practice Address - Street 1:3372 W SOUTHPORT RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2706
Practice Address - Country:US
Practice Address - Phone:407-933-7900
Practice Address - Fax:321-437-0072
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15596208D00000X
FLACN790208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1136362OtherCAREPLUS
FL200000039833OtherULTIMATE HEALTH
FLLX2J49-AEOtherDEVOTED
FLT8F03OtherFLORIDA BLUE
FLP1042908OtherFREEDOM
FL05584642OtherSIMPLY
FL6831972OtherAETNA
FLQMP000004790310OtherCIGNA
FLT8F03OtherFLBLUE
FLP978389OtherOPTIMUM
FLP66439464OtherUHC
FL2938801OtherWEELLCARE