Provider Demographics
NPI:1467242784
Name:DIEGUEZ, LIXY (FNP)
Entity type:Individual
Prefix:MRS
First Name:LIXY
Middle Name:
Last Name:DIEGUEZ
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 NW 240TH ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-7019
Mailing Address - Country:US
Mailing Address - Phone:772-579-1167
Mailing Address - Fax:
Practice Address - Street 1:6320 NW 240TH ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-7019
Practice Address - Country:US
Practice Address - Phone:772-579-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF05250034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily