Jorge Enrique De la Rotta Soto, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11001660 Issued in FL

Practice address

90 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5114

Phone

(904) 377-2675

NPI assigned

Mar 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Integrative Healthcare IncGroup PAC ID 2264651074, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Coastal Integrative Healthcare Inc

  • Nurse Practitioner
  • Edgewater, FL
  • NPI 1093126203
  Medicare reassignment Care Compare group
• Family First Primary Care PA

  • Primary Care Clinic/Center
  • Orange Park, FL
  • NPI 1942481429
  Medicare reassignment
• Health Consulting Associates LLC

  • Urgent Care Clinic/Center
  • North Miami Beach, FL
  • NPI 1194112219
  NPD
• PA Surgical Inc

  • Surgical Physician Assistant
  • Boca Raton, FL
  • NPI 1942313879
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1245791078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 FORT WADE RD STE 100",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815114",
            "telephone_number": "904-377-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FORT WADE RD STE 100",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815114",
            "telephone_number": "904-377-2675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Oakleaf Plantation Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320653626",
            "country_code": "US",
            "telephone_number": "904-282-4565",
            "fax_number": "904-282-4225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA ROTTA SOTO",
        "first_name": "JORGE",
        "middle_name": "ENRIQUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Catherine Coughlin
• Covenant Counseling Services Inc
• William C Cullen, DMD
• Daniel M Calloway MD PA
• Jill A Darnell, RPH
• Joshua Michael Dearth, PA-C
• Carla Marie Defuria, MBA, RDN, LDN
• Sherry Dianne Dekeyser, M.D.
• Deliver PT, LLC
• Charles Michael Dellinger, PHARM.D.

• Family Nurse Practitioner in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.