Provider Demographics
NPI:1174615553
Name:BUKATY, CHRISTINA (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:BUKATY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21543 BELVEDERE LN
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-7333
Mailing Address - Country:US
Mailing Address - Phone:716-545-5757
Mailing Address - Fax:
Practice Address - Street 1:7051 CYPRESS TERRACE SUITE 106 ROOM 101
Practice Address - Street 2:
Practice Address - City:FORT MEYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:716-545-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009117-2111N00000X
FLCH13702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU70091Medicare UPIN
NYAA1682Medicare ID - Type Unspecified