Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A92285 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | ME96710 | FL |
NPI | 1154471977 |
---|---|
Provider Name | Joshua A. Gottschall |
First Address | Orlando, FL 32835-5718 |
Second Address | Orlando, FL 32835-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 10/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A922850 | (05) | CA |
I44890 | (02) |