| Glo Aesthetic & Laser Institute Llc | |
|
7100 W Camino Real Suite 206 Boca Raton FL 33433-5510 | |
| (561) 704-4565 | |
| (561) 368-2264 |
| Full Name | Glo Aesthetic & Laser Institute Llc |
|---|---|
| Speciality | Dermatology - Procedural Dermatology |
| Location | 7100 W Camino Real, Boca Raton, Florida |
| Authorized Official Name and Position | Jack Alan Danton (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5617044565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glo Aesthetic & Laser Institute Llc 7945 Palacio Del Mar Dr Boca Raton FL 33433-4149 Ph: (561) 704-4565 | Glo Aesthetic & Laser Institute Llc 7100 W Camino Real Suite 206 Boca Raton FL 33433-5510 Ph: (561) 704-4565 |
| NPI Number | 1013189075 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013189075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS6841 (Florida) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | OS6841 (Florida) | Primary |
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