Organization
MINOR MEDICAL SQUAD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL VITO DIMUCCI FNP-C (OWNER, FAMILY NURSE PRACTITIONER)
(612) 805-8676
Entity
Organization
Contact information
Practice address
5775 WAYZATA BLVD STE 700, ST LOUIS PARK, MN 55416-1233
(612) 504-6160
(855) 818-2050
Mailing address
826 TRENTON LN N, PLYMOUTH, MN 55441-4496
(612) 805-8676
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
09/11/2025
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