MEDICARE: DR. JOSE GONZALEZ SOTO APRN, PMHNP-BC, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH23658	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F407540-01	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11026930	FL

General Provider Information

NPI Number	:	1437839321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE GONZALEZ SOTO APRN, PMHNP-BC, LMHC

Provider Business Mailing Address
First Line	:	14021 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2401
Country	:	US
Telephone Number	:	813-710-6513
Fax Number	:	385-473-8371

Provider Business Practice Location Address
First Line	:	4350 W CYPRESS ST STE 625
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4293
Country	:	US
Telephone Number	:	855-817-8607
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	03/23/2026

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