Healthcare Provider Details

I. General information

NPI: 1437839321
Provider Name (Legal Business Name): JOSE GONZALEZ-SOTO APRN, PMHNP-BC, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 W CYPRESS ST STE 625
TAMPA FL
33607-4293
US

IV. Provider business mailing address

7402 N 56TH ST STE 355 PMB 2090
TAMPA FL
33617
US

V. Phone/Fax

Practice location:
  • Phone: 855-817-8607
  • Fax:
Mailing address:
  • Phone: 813-303-6871
  • Fax: 385-473-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23658
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF407540-01
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11026930
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: