Individual provider Active NPI

Marielita Soto, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1164053633
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11005667 Issued in FL
Practice address
780 Buenaventura Blvd
Kissimmee, FL 34743-8128
Phone
(407) 344-9959
Fax
(833) 450-5405
NPI assigned
Feb 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11005667 FL Primary

Addresses

Primary practice location

780 Buenaventura Blvd
Kissimmee, FL 34743-8128

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (321) 332-6947

Other identifiers 1

IdentifierTypeStateIssuer
108583500MedicaidFL

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
I20201118002409 FL Practitioner - Nurse Practitioner 7113338385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12301 Lake Underhill Rd
Suite 215
Orlando, FL 32828-4508

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11005667FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Doctors Center Inc CurrentSince Sep 29, 2025 Accepting new patients
Orlando Family Physicians, LLC PastSince Dec 18, 2017 Accepting new patients
Central Florida Family Health Center Inc PastSince Jan 9, 2023 Accepting new patients
Orlando Family Physicians, LLC PastSince Jul 25, 2021 Accepting new patients

Locations

2255 Dunn Ave
Ste 100
Jacksonville, FL 32218
Phone (904) 292-0322

280 Wekiva Springs Rd
Ste 1000
Longwood, FL 32779
Phone (407) 788-2273

7824 Lake Underhill Rd
Ste B
Orlando, FL 32822
Phone (407) 281-0470

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: marielita.soto.1@25165.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1164053633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-332-6947",
            "fax_number": "689-304-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 BUENAVENTURA BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347438128",
            "telephone_number": "407-344-9959",
            "fax_number": "833-450-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "MARIELITA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108583500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.