Glo Aesthetic & Laser Institute Llc

NPI 1013189075 - Family Medicine - 207Q00000X

NPI Details
NPI 1013189075
Enumeration Date 03/31/2008
Last Updated 12/03/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name JACK ALAN JACK
Position MEDICAL DIRECTOR
Phone (561) 704-4565
Fax (561) 368-2264
Practice Location
7100 W CAMINO REAL
SUITE 206
BOCA RATON FL, 33433-5510, US
Phone (561) 704-4565
Fax (561) 368-2264
Business Location
7945 PALACIO DEL MAR DR
BOCA RATON FL, 33433-4149, US
Phone (561) 704-4565
Fax (561) 368-2264
Toxanomy
Taxonomy Code 207Q00000X
License State Florida
License Number OS6841
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According to our database, Glo Aesthetic & Laser Institute Llc NPI is 1013189075, taxonomy code is 207Q00000X and license number is OS6841, license state is located at Florida. Glo Aesthetic & Laser Institute Llc physically located at 7100 W Camino Real, Boca Raton FL, 33433-5510. NPI Number 1033115704 has the healthcare provider type.

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1013189075 NPI number is provided on an as is basis without warranty of any kind. 1013189075 is maintained by the National Plan & Provider Enumeration System. The contents of Glo Aesthetic & Laser Institute Llc are for informational purposes only.