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

Boutique Dermatology LLC

Organization Dermatology Physician · NPI 1336971449

Boutique Dermatology LLC is a Dermatology Physician in Winter Park, Florida. Registered with an NPI since 2024.

In the registry since
2024
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

1400 S Orlando Ave Ste 101
Winter Park, FL 32789-5543
Phone: (407) 305-9195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1336971449
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shelley Fox — Authorized Official · (321) 439-9505
NPI enumeratedAugust 16, 2024
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024
Mailing address1400 S Orlando Ave Ste 101, Winter Park, FL 32789-5543

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