Individual provider Active NPI

Maylin Rodriguez Fernandez, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1528744950
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11027117 Issued in FL
Practice address
12590 Whitehall Dr Ste 3
Fort Myers, FL 33907-4680
Phone
(239) 939-9090
NPI assigned
Jun 22, 2023
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11027117 FL Primary

Addresses

Primary practice location

12590 Whitehall Dr Ste 3
Fort Myers, FL 33907-4680

Mailing address

12590 Whitehall Dr
Fort Myers, FL 33907-4680
Phone (239) 939-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808000183 FL Practitioner - Nurse Practitioner 1557722535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mi Dynamic Medical Group LLCGroup PAC ID 7911408190, 2 clinicians

Practice addresses (Care Compare)

1222 SE 47TH St
Suite 201
Cape Coral, FL 33904-9602
Phone (239) 342-6516

4310 Metro Pkwy
Suite 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027117FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Sep 2, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Sep 2, 2024 Accepting new patients
Mi Dynamic Medical Group LLC Psychiatric/Mental Health CurrentSince Jul 14, 2025 Accepting new patients
Ivan L Mazzorana Jr MD PA Psychiatric/Mental Health CurrentSince Jun 29, 2023 Accepting new patients

Locations

1222 SE 47th St
Ste 201
Cape Coral, FL 33904
Phone (239) 234-9355

12590 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 939-9090

12590 Whitehall Dr
Ste 3
Fort Myers, FL 33907
Phone (239) 936-9338

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: maylin.rodriguez.fernandez.1@13142.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1528744950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12590 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074680",
            "telephone_number": "239-939-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12590 WHITEHALL DR STE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074680",
            "telephone_number": "239-939-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ FERNANDEZ",
        "first_name": "MAYLIN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11027117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.