Healthcare Provider Details

I. General information

NPI: 1568398246
Provider Name (Legal Business Name): ILSE MARIA MACMASTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 SW 29TH TER
OCALA FL
34474-2992
US

IV. Provider business mailing address

1807 SW 29TH TER
OCALA FL
34474-2992
US

V. Phone/Fax

Practice location:
  • Phone: 352-857-7770
  • Fax:
Mailing address:
  • Phone: 352-857-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9565934
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: