Dermatology Boutique PA
NPI 1104225887 · Dermatology Physician · Hallandale Beach, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Dermatology Boutique PA is a Dermatology Physician organization in Hallandale Beach, FL (NPI 1104225887).
Provider details
- NPI number
- 1104225887
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cynthia Golomb, Owner(855) 465-6621
- License
- ME74763 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-08-18
- Last updated
- 2020-02-25
- Certified
- 2020-02-25
Frequently asked questions
- What is Dermatology Boutique PA's NPI number?
- Dermatology Boutique PA's National Provider Identifier (NPI) is 1104225887, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Dermatology Boutique PA?
- Dermatology Boutique PA is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Dermatology Boutique PA located?
- Dermatology Boutique PA's practice location on file with NPPES is 110 N Federal Hwy, Hallandale Beach, FL 33009-4300.
- What is Dermatology Boutique PA's phone number?
- The practice phone number listed in the NPPES registry for Dermatology Boutique PA is (855) 465-6621.
- Does Dermatology Boutique PA accept Medicare?
- Dermatology Boutique PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Dermatology Boutique PA?
- The authorized official listed on Dermatology Boutique PA's NPPES record is Cynthia Golomb, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Dermatology Boutique PA's NPI active?
- Yes — Dermatology Boutique PA's NPI (1104225887) is active in the NPPES registry as of the last update on 2020-02-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.