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Contact Information

BOUTIQUE DERMATOLOGY LLC
1400 S ORLANDO AVE STE 101
WINTER PARK, FL32789-5543
 Phone: 407-305-9195
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for BOUTIQUE DERMATOLOGY LLC · (Female)

NPI # 1336971449
Status Active
Credentials
Entity Individual
Enumeration date 08/16/2024
Last updated 08/16/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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