Active NPI
Joel David Gonzalez-Mendez, M.D.
- General Practice Physician
- Kissimmee, FL
National Provider Identifier
1811910060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ACN790
- Practice address
- 3372 W Southport Rd
Kissimmee, FL 34746-2706 - Phone
- (407) 933-7900
- Fax
- (321) 437-0072
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 15596 | PR | |
| General Practice Physician | 208D00000X | ACN790 | FL | Primary |
Addresses
Primary practice location
3372 W Southport Rd
Kissimmee, FL 34746-2706
Mailing address
6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1136362 | Other | FL | CAREPLUS |
| 200000039833 | Other | FL | ULTIMATE HEALTH |
| LX2J49-AE | Other | FL | DEVOTED |
| T8F03 | Other | FL | FLORIDA BLUE |
| P1042908 | Other | FL | FREEDOM |
| 05584642 | Other | FL | SIMPLY |
| 6831972 | Other | FL | AETNA |
| QMP000004790310 | Other | FL | CIGNA |
| T8F03 | Other | FL | FLBLUE |
| P978389 | Other | FL | OPTIMUM |
| P66439464 | Other | FL | UHC |
| 2938801 | Other | FL | WEELLCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160926001138 | FL | Practitioner - General Practice | 9436103108 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACN790 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Home Alliance LLC | Past | Accepting new patients | |
| Family Health Group S.S.C.S.P | General Practice | Past | Accepting new patients |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba IMA Winter Haven Dispensary
- Non-Pharmacy Dispensing Site
- Winter Haven, FL
- NPI 1033648233
-
- General Practice Physician
- San Sebastian, PR
- NPI 1700962586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1811910060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6675 WESTWOOD BLVD STE 475",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328216027",
"telephone_number": "407-845-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3372 W SOUTHPORT RD",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347462706",
"telephone_number": "407-933-7900",
"fax_number": "321-437-0072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ-MENDEZ",
"first_name": "JOEL",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "15596",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREPLUS",
"identifier": "1136362",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ULTIMATE HEALTH",
"identifier": "200000039833",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVOTED",
"identifier": "LX2J49-AE",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "T8F03",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FREEDOM",
"identifier": "P1042908",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIMPLY",
"identifier": "05584642",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "6831972",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "QMP000004790310",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLBLUE",
"identifier": "T8F03",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM",
"identifier": "P978389",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "P66439464",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEELLCARE",
"identifier": "2938801",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.