OrganizationActive
Glo Aesthetic & Laser Institute LLC
NPI 1013189075 · Procedural Dermatology Physician · Boca Raton, FL
Provider details
- NPI number
- 1013189075
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jack Danton, Medical Director(561) 704-4565
- License
- OS6841 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
7100 W Camino Real
Suite 206
Boca Raton, FL 33433-5510
Phone: (561) 704-4565
Fax: (561) 368-2264
Approximate (ZIP-level) locationGet directions
Mailing address
7945 Palacio Del Mar Dr
Boca Raton, FL 33433-4149
Other names (DBA / former)
- Doing business as
- Boca Vip Dermatology & Laser Institute
Registry dates
- Enumerated
- 2008-03-31
- Last updated
- 2008-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.