MEDICARE: MRS. LIXY DIEGUEZ FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F05250034	FL

General Provider Information

NPI Number	:	1467242784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LIXY DIEGUEZ FNP

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	321-332-6947
Fax Number	:	689-304-0303

Provider Business Practice Location Address
First Line	:	6320 NW 240TH ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-7019
Country	:	US
Telephone Number	:	772-579-1167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2025
Last Update Date	:	05/07/2026

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