| Jaymielee Soto Llc | |
|
1210 Solstice Loop Sanford FL 32771-0046 | |
| (787) 642-6147 | |
| Not Available |
| Full Name | Jaymielee Soto Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1210 Solstice Loop, Sanford, Florida |
| Authorized Official Name and Position | Jaymielee Soto Diaz (OWNER) |
| Authorized Official Contact | 7876426147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaymielee Soto Llc 1210 Solstice Loop Sanford FL 32771-0046 Ph: (787) 642-6147 | Jaymielee Soto Llc 1210 Solstice Loop Sanford FL 32771-0046 Ph: (787) 642-6147 |
| NPI Number | 1134993603 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Medicare PECOS PAC ID | 7315397155 |
|---|---|
| Medicare Enrollment ID | O20231220001451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134993603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jaymielee Soto Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356005771 PECOS PAC ID: 0840689832 Enrollment ID: I20211112000983 |
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