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

Boutiq Medical Clinic LLC

Organization Primary Care Clinic/Center · NPI 1558947499

Boutiq Medical Clinic LLC is a Primary Care Clinic/Center in Orlando, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1430 N Mills Ave Ste 120
Orlando, FL 32803-1877
Phone: (407) 777-2449
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1558947499
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Buckalew — President/Owner · (407) 777-2449
NPI enumeratedMarch 22, 2021
Last updated in NPPESApril 7, 2021
Certification dateApril 7, 2021
Mailing address1815 Gerda Ter, Orlando, FL 32804-5934

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