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General NPI Number Information
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NPI Number | 1043109747
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Entity Type | Individual
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Provider Name | ASHLEY MACISAAC APRN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1213 E LAS OLAS BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2331
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Country | US
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Telephone | 954-982-2841
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Fax |
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Provider Business Mailing Address
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Address Line | 104 VIA CASTILLA
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City | JUPITER
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State | FL
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Zip | 33458-6919
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Country | US
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Telephone | 774-262-3552
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | APRN11039669
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License Number State | FL
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