Organization
NORTHLAKE MEDICAL
Active
Other names
Chiropractic & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ALBERT FORTUNATO (PRESIDENT)
(561) 627-8602
Entity
Organization
Contact information
Practice address
3450 NORTHLAKE BLVD, LAKE PARK, FL 33403
(561) 627-8602
(561) 627-8603
Mailing address
3450 NORTHLAKE BLVD, LAKE PARK, FL 33403
(561) 627-8602
(561) 627-8603
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/02/2008
Last updated
07/14/2008
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