Dermatology Boutique PA
NPI 1104225887ActiveOrganization· Dermatology· Hallandale Beach, FL
Dermatology in Hallandale Beach, Florida, registered in NPPES in August 2014. The authorized official on file is Cynthia Ann Golomb, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104225887 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 18, 2014 |
| Last updated in NPPES | Feb 25, 2020 |
| Certified by provider | Feb 25, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | ME74763 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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