Individual provider Active NPI

Jaymielee Soto Diaz, PSYD

  • Clinical Psychologist
  • Orlando, FL
National Provider Identifier
1356005771
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY11247 Issued in FL
Practice address
8207 Forest City Rd
Orlando, FL 32810-2354
Phone
(787) 642-6147
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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 PY11247 FL Primary

Addresses

Primary practice location

8207 Forest City Rd
Orlando, FL 32810-2354

Mailing address

1210 Solstice Loop
Sanford, FL 32771-0046
Phone (787) 642-6147

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211112000983 FL Practitioner - Clinical Psychologist 0840689832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

145 Tollgate TRL
Longwood, FL 32750-3858
Phone (787) 642-6147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY11247FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transformative Healthcare Solutions Inc Clinical CurrentSince Oct 22, 2021 Accepting new patients
Jaymielee Soto LLC Clinical CurrentSince Nov 15, 2023 Accepting new patients
Soto Diaz PA Clinical CurrentSince Nov 15, 2023 Accepting new patients
Pro Performance Physical Therapy LLC PastSince Jun 26, 2019 Accepting new patients

Locations

2544 E Sunrise Blvd
Fort Lauderdale, FL 33304
Phone (954) 253-0853

1848 SE 1st Ave
Ft Lauderdale, FL 33316
Phone (954) 366-2700

8207 Forest City Rd
Orlando, FL 32810
Phone (407) 295-4861

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.

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1356005771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SOLSTICE LOOP",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327710046",
            "telephone_number": "787-642-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 FOREST CITY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102354",
            "telephone_number": "787-642-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO DIAZ",
        "first_name": "JAYMIELEE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.