Healthcare Provider Details

I. General information

NPI: 1063222503
Provider Name (Legal Business Name): BUKATY FAMILY CHIROPRACTIC OF FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21105 DESIGN PARC LN STE 102
ESTERO FL
33928-6437
US

IV. Provider business mailing address

21543 BELVEDERE LN
ESTERO FL
33928-7333
US

V. Phone/Fax

Practice location:
  • Phone: 239-770-1133
  • Fax:
Mailing address:
  • Phone: 716-545-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHRISTINA BUKATY
Title or Position: CEO
Credential:
Phone: 716-545-5757