Individual
ISMAEL MACALLA-RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
5216 CLAYTON CT, FORT MYERS, FL 33907-2116
(239) 343-8260
(239) 343-4258
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-8260
(239) 343-4258
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN11014693
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11014693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118721400
—
FL
Enumeration date
08/04/2021
Last updated
05/28/2025
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