Healthcare Provider Details

I. General information

NPI: 1467242784
Provider Name (Legal Business Name): LIXY DIEGUEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N JOHN YOUNG PKWY
KISSIMMEE FL
34741-4914
US

IV. Provider business mailing address

425 W COLONIAL DR
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 407-956-1920
  • Fax: 833-450-5410
Mailing address:
  • Phone: 321-332-6947
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05250034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: