Individual provider Active NPI

Deborah M Soldo

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407406457
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11003601 Issued in FL
Practice address
611 E Adams St
Jacksonville, FL 32202-2847
Phone
(904) 359-0457
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11003601 FL Primary

Addresses

Primary practice location

611 E Adams St
Jacksonville, FL 32202-2847

Mailing address

611 E Adams St
Jacksonville, FL 32202-2847
Phone (904) 359-0457

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
I20210909001833 FL Practitioner - Nurse Practitioner 2365848793 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Im Sulzbacher Center for the Homeless, Inc CurrentSince Mar 27, 2024 Accepting new patients
Baptist Primary Care Inc CurrentSince Sep 13, 2021 Accepting new patients
Baptist Primary Care Inc CurrentSince Sep 13, 2021 Accepting new patients
Im Sulzbacher Center for the Homeless, Inc CurrentSince Mar 27, 2024 Accepting new patients
Birth and Beyond PastSince Apr 1, 2021 Accepting new patients

Locations

611 E Adams St
Jacksonville, FL 32202
Phone (904) 359-0457

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

850 6th Ave S
Ste 500
Jacksonville Beach, FL 32250
Phone (904) 224-3550

850 6th Ave S
Jacksonville Beach, FL 32250
Phone (904) 224-3550

769 Blanding Blvd
Ste 7
Orange Park, FL 32065
Phone (904) 458-4882

Organizations & group practices 5

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1407406457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-359-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-359-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLDO",
        "first_name": "DEBORAH",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11003601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.