Individual provider Active NPI

Felix Alexander Soleh, APRN, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Fernandina Beach, FL
National Provider Identifier
1073126140
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11009930 Issued in FL
Practice address
1896 S 14TH St
Fernandina Beach, FL 32034-1999
Phone
(904) 310-9652
Fax
(904) 467-3143
NPI assigned
Aug 28, 2020
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11009930 FL Primary

Addresses

Primary practice location

1896 S 14TH St
Fernandina Beach, FL 32034-1999

Mailing address

3333 W 20TH St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

Other practice location 1

3333 W 20th St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211124001100 FL Practitioner - Nurse Practitioner 3375933823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Resource Center IncGroup PAC ID 2567446982, 14 clinicians

Practice addresses (Care Compare)

3333 W 20TH St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11009930FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc CurrentSince Sep 21, 2021 Accepting new patients
Mental Health Center of Jacksonville, Inc. PastSince Sep 21, 2021 Accepting new patients

Locations

11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100

3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364

4427 Emerson St
Ste 5
Jacksonville, FL 32207
Phone (904) 745-0042

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1073126140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W 20TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541703",
            "telephone_number": "904-695-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341999",
            "telephone_number": "904-310-9652",
            "fax_number": "904-467-3143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W 20th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322541703",
            "country_code": "US",
            "telephone_number": "904-695-9145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLEH",
        "first_name": "FELIX",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "APRN, PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11009930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.