Provider Demographics
NPI:1144405473
Name:DR. ELANA BUTTIGHERI CIBULA
Entity Type:Organization
Organization Name:DR. ELANA BUTTIGHERI CIBULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELANA
Authorized Official - Middle Name:BUTTIGHERI
Authorized Official - Last Name:CIBULA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:239-261-6672
Mailing Address - Street 1:2830 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4414
Mailing Address - Country:US
Mailing Address - Phone:239-261-6672
Mailing Address - Fax:239-261-6043
Practice Address - Street 1:2830 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4414
Practice Address - Country:US
Practice Address - Phone:239-261-6672
Practice Address - Fax:239-261-6043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2809261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65694Medicare PIN
FL4558460001Medicare NSC
FLT92797Medicare UPIN