Individual provider Active NPI

Jennifer Marie Gonzalez, PA-C, LAT, ATC

  • Medical Physician Assistant
  • Apopka, FL
National Provider Identifier
1952707986
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9115134 Issued in FL
Practice address
225 E 7TH St
Apopka, FL 32703-5327
Phone
(407) 905-8827
Fax
(407) 886-4282
NPI assigned
Nov 19, 2014
Reactivated
Oct 28, 2021
Last updated
Apr 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9115134 FL Primary
Athletic Trainer 2255A2300X AL3861 FL

Addresses

Primary practice location

225 E 7TH St
Apopka, FL 32703-5327

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other practice location 1

730 NW 107th Ave Ste 210
Miami, FL 33172-3104
Phone (305) 702-0336

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230509001752 FL Practitioner - Physician Assistant 6103282595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AL3861FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc CurrentSince May 8, 2023 Accepting new patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince May 8, 2023 Accepting new patients
Impower, Inc Medical Past Accepting new patients

Locations

225 E 7th St
Apopka, FL 32703
Phone (407) 886-6201

7900 Forest City Rd
Orlando, FL 32810
Phone 40790588271001

840 Mercy Dr
Pine Hills, FL 32808
Phone 4079058827 ext. 2997

110 S Woodland St
Winter Garden, FL 34787

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1952707986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 7TH ST",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035327",
            "telephone_number": "407-905-8827",
            "fax_number": "407-886-4282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 NW 107th Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331723104",
            "country_code": "US",
            "telephone_number": "305-702-0336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-19",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "deactivation_date": "2021-10-08",
        "reactivation_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115134",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.