Provider Demographics
NPI:1023982733
Name:JOSE GONZALEZ-SOTO, PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER, PLLC
Entity type:Organization
Organization Name:JOSE GONZALEZ-SOTO, PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADDICTION & PSYCHIATRIC NP
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GONZALEZ-SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,PMHNP-BC,CARN-AP
Authorized Official - Phone:813-303-6871
Mailing Address - Street 1:7402 N 56TH ST STE 355
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7700
Mailing Address - Country:US
Mailing Address - Phone:813-303-6871
Mailing Address - Fax:
Practice Address - Street 1:1044 E BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5509
Practice Address - Country:US
Practice Address - Phone:813-303-6871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty