Diana Isabel Clavijo
Nurse Practitioner, Family in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1003671629
StatusActive
Last updated in NPPESMay 16, 2026
Details
- NPI
- 1003671629
- Entity type
- Individual (NPI-1)
- Name
- Diana Isabel Clavijo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 14, 2024
- Certification date
- May 16, 2026
- Last updated
- May 16, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11030622 | FL | Yes |
Practice location
1170 Sw Bayshore Blvd Ste 100Port St Lucie, FL 34983-2408
Phone 772-309-0030 · Fax 855-538-2084
Mailing address
1170 Sw Bayshore Blvd Ste 100Port St Lucie, FL 34983-2408
Phone 772-309-0030 · Fax 855-538-2084
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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