NORTHLAKE MEDICAL CENTER (NPI# 1215092697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215092697 |
| Entity Type | Organization |
| Organization Name | NORTHLAKE MEDICAL CENTER |
| Practice Address |
4300 Northlake Blvd Palm Beach Gardens FL 33410-6254 |
| Practice Telephone | 5616269190 |
| Practice Fax Number | 5616267274 |
| Mailing Telephone | 5616269190 |
| Mailing Fax Number | 5616267274 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT WILLIAM MACKLER (OWNER) |
| Authorized Official Telephone | 5616269192 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAL LICENSE NUMBER | ME39831 | 01 |
| Street Address |
4300 NORTHLAKE BLVD |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33410-6254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255477501 | Robert Mackler | Family Medicine | 4300 Northlake Blvd, Palm Beach Gardens, FL 33410 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811501026 | Vicky Pauline Salazar | Registered Nurse | 11501 N Military Trail, Palm Beach Gardens, FL 33410 | 2020-09-04 |
| 1417596388 | Chavon E Mayer | Doula | 149 Winter Park Lane, West Palm Beach, FL 33410 | 2019-12-24 |
| 1639711617 | Diamond Physical Therapy, LLC | Physical Therapist | 4025 Johnson Dairy Road, Palm Beach Gardens, FL 33410 | 2019-10-11 |
| 1689151714 | Caroline Devries Hesterman | Occupational Therapist | 9840 Alternate A1a Ste 402, Palm Beach Gardens, FL 33410 | 2018-07-21 |
| 1366937088 | Krystal Maya Khemkaran | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410 | 2018-06-25 |
| 1548762552 | Arsenia Pomperada Sabusap | Nurse Practitioner | Grace Medical Center of Florida, 4212 Northlake Blvd., Palm Beach Gardens, FL 33410 | 2018-03-06 |
| 1538668199 | Alan Seidenfeld | Dentist | 7305 N Military Trl 3a-200, Riviera Beach, FL 33410 | 2018-02-08 |
| 1407361454 | Nuvista Living At Jupiter, LLC | Skilled Nursing Facility | 338 Pioneer Road, Jupiter, FL 33410 | 2017-12-12 |
| 1083125728 | Tom Long Biddle-xing | Nurse Practitioner | 3345 Burns Rd Ste 206, Palm Beach Gardens, FL 33410 | 2017-10-20 |
| 1801315189 | Kasie Sidman | Physical Therapist | 3929 Bluebell St, Palm Beach Gardens, FL 33410 | 2017-09-18 |
| Find all providers in zip 33410 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497920771 | Hope Health and Wellness Inc | Clinic/Center | 4360 Northlake Blvd Ste 105, Palm Beach Gardens, FL 33410-6265 | 2008-04-28 |
| 1477918969 | Michelle Carrillo-massa, M.d., P.a. | Clinic/Center | 11211 Prosperity Farms Rd, Suite D127, Palm Beach Gardens, FL 33410-3446 | 2015-12-28 |
| 1841632106 | Cleveland Clinic | Clinic/Center | 4520 Donald Ross Rd, Suite 200, Palm Beach Gardens, FL 33418-5105 | 2013-07-26 |
| 1306008404 | Jove Medical, Inc. | Clinic/Center | 12300 Highway A1a Alt, Suite 112, Palm Beach Gardens, FL 33410-2205 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122337 | Life Line Medical Group Inc | Clinic/Center | 12595 Sw 137th Ave Ste 206, Miami, FL 33186-4221 | 2020-10-20 |
| 1558977926 | Ohi West Medical Group, LLC | Clinic/Center | 603 7th St S Ste 350, St Petersburg, FL 33701-4732 | 2020-09-21 |
| 1205441615 | Washington Hills Primary Care | Clinic/Center | 4645 Plantation Oaks Blvd, Orange Park, FL 32065-3652 | 2020-09-11 |
| 1699380329 | Premier Health System LLC | Clinic/Center | 12970 Sw 133rd Ct Ste A, Miami, FL 33186-5806 | 2020-09-10 |
| 1093328163 | Sunmed Group LLC | Clinic/Center | 2499 Glades Rd Ste 305a, Boca Raton, FL 33431-7202 | 2020-08-28 |
| 1790398246 | Emc 360, LLC | Clinic/Center | 1008 Juliette Blvd, Mount Dora, FL 32757-6500 | 2020-08-25 |
| 1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
| 1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
| 1912517152 | Curos Inc | Clinic/Center | 1425 Sw 8th Ct, Ft Lauderdale, FL 33312-7291 | 2020-08-03 |
| 1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33410 |
Please comment or provide details below to improve the information on NORTHLAKE MEDICAL CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.