Individual provider Active NPI

Elia Enid Villalobos Soto, PSYD

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1336636489
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10895 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(813) 844-3541
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10895 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-3541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029

6415 Lake Worth Rd
Suite 102
Greenacres, FL 33463-3009

PO Box
Suite 1289
Tampa, FL 33601

PO Box
Suite 1289
Tampa, FL 33601-1289

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10895FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Florida Health Sciences Center Inc CurrentSince Mar 1, 2022 Accepting new patients
Tampa General Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Tampa General Medical Group Inc Clinical Current Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Freedom Health HMO Network

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 1

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": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1336636489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS SOTO",
        "first_name": "ELIA ENID",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.