Individual
DIANA ISABEL CLAVIJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1170 SW BAYSHORE BLVD STE 100, PORT ST LUCIE, FL 34983-2408
(772) 309-0030
(855) 538-2084
Mailing address
1170 SW BAYSHORE BLVD STE 100, PORT ST LUCIE, FL 34983-2408
(772) 309-0030
(855) 538-2084
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11030622
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
11030622
FL
Other
Enumeration date
02/14/2024
Last updated
05/16/2026
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