Individual provider Active NPI

Autumn Soliz, PSY.D.

  • Psychologist
  • St Petersburg, FL
National Provider Identifier
1245753862
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY10550 Issued in FL
Practice address
401 Pasadena Ave S
St Petersburg, FL 33707-2101
Phone
(727) 495-6302
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY10550 FL Primary

Addresses

Primary practice location

401 Pasadena Ave S
St Petersburg, FL 33707-2101

Mailing address

401 Pasadena Ave S
St Petersburg, FL 33707-2101
Phone (727) 495-6302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY10550FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1245753862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PASADENA AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337072101",
            "telephone_number": "727-495-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PASADENA AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337072101",
            "telephone_number": "727-495-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIZ",
        "first_name": "AUTUMN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.