Healthcare Provider Details

I. General information

NPI: 1174615553
Provider Name (Legal Business Name): CHRISTINA BUKATY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 CYPRESS TERRACE SUITE 106 ROOM 101
FORT MEYERS FL
33907
US

IV. Provider business mailing address

21543 BELVEDERE LN
ESTERO FL
33928-7333
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009117-2
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH13702
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: