Individual
DR. JAYMES GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3115 INNOVATION DR, SAINT CLOUD, FL 34769-6501
(407) 530-7304
Mailing address
3115 INNOVATION DR, SAINT CLOUD, FL 34769-6501
(407) 892-5700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20043323B
IN
103TC0700X
Clinical Psychologist
Primary
9065
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024324400
—
FL
05
—
300054391
—
IN
Enumeration date
11/08/2012
Last updated
05/18/2023
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