Boutique Dermatology LLC
NPI 1336971449ActiveOrganization· Dermatology· Winter Park, FL
Dermatology in Winter Park, Florida, registered in NPPES in August 2024. The authorized official on file is Shelley Fox, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1336971449 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 16, 2024 |
| Last updated in NPPES | Aug 16, 2024 |
| Certified by provider | Aug 16, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
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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