Healthcare Provider Details

I. General information

NPI: 1841041795
Provider Name (Legal Business Name): YULEIDI DIEGUEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S GOLDENROD RD STE B
ORLANDO FL
32822-8113
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 407-362-0148
  • Fax:
Mailing address:
  • Phone: 210-630-2207
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03240601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: