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Organization
MI DYNAMIC MEDICAL GROUP LLC
Active
Organization
MI DYNAMIC MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVETTE DIEGUEZ (APRN)
(239) 342-6516
Entity
Organization
Contact information
Practice address
1222 SE 47TH ST STE 201, CAPE CORAL, FL 33904-9602
(239) 342-6516
(239) 374-8342
Mailing address
1222 SE 47TH ST STE 201, CAPE CORAL, FL 33904-9602
(239) 342-6516
(239) 374-8342
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/12/2025
Last updated
01/27/2026
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