Provider Demographics
NPI:1437839321
Name:GONZALEZ SOTO, JOSE (APRN, PMHNP-BC, LMHC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:GONZALEZ SOTO
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7402 N 56TH ST STE 355 PMB 2090
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14702 N FLORIDA AVE STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1822
Practice Address - Country:US
Practice Address - Phone:813-945-7922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23658101YM0800X
NYF407540-01363LP0808X
FL11026930363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health