Organization
NORTHLAKE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WILLIAM MACKLER M.D. (OWNER)
(561) 626-9192
Entity
Organization
Contact information
Practice address
4300 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33410-6254
(561) 626-9190
(561) 626-7274
Mailing address
4300 NORTHLAKE BLVD, PALM BEACH GARDENS, FL 33410-6254
(561) 626-9190
(561) 626-7274
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME39831
MEDICAL LICENSE NUMBER
FL
Enumeration date
12/26/2006
Last updated
08/22/2020
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