Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dermatology Boutique PA

Organization Dermatology Physician · NPI 1104225887

Dermatology Boutique PA provides Dermatology Physician services in Hallandale Beach, Florida. Licensed in Florida. Registered with an NPI since 2014.

Licensed in
FL
In the registry since
2014
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

110 N Federal Hwy Ste 302
Hallandale Beach, FL 33009-4300
Phone: (855) 465-6621
Fax: (888) 407-3376
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence ME74763 (FL)

Record details

NPI number1104225887
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cynthia Golomb — Owner · (855) 465-6621
NPI enumeratedAugust 18, 2014
Last updated in NPPESFebruary 25, 2020
Certification dateFebruary 25, 2020
Mailing address100 N Federal Hwy Ste 202, Hallandale Beach, FL 33009-4373

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