Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lianet Lantigua Ponce de Leon

Individual provider Family Nurse Practitioner · NPI 1265122584

Lianet Lantigua Ponce de Leon is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2022, 4 years ago. Accepts Medicare assignment. Licensed in Arizona and Florida.

Years since qualifying
4
Licensed in
AZ, FL
In the registry since
2023
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

10645 N 43rd Ave
Phoenix, AZ 85029-3944
Phone: (623) 233-2006
Fax: (602) 314-6115
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN305992 (AZ)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F05230008 (FL)

Record details

NPI number1265122584
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 10, 2023
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Phoenix