Provider Demographics
NPI:1295781391
Name:CIBULA, ELANA BUTTIGHERI (DPM)
Entity type:Individual
Prefix:DR
First Name:ELANA
Middle Name:BUTTIGHERI
Last Name:CIBULA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:LOUISE
Other - Last Name:BUTTIGHERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:2830 TAMIAMI TR N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:239-261-6672
Mailing Address - Fax:239-261-6043
Practice Address - Street 1:2830 TAMIAMI TR N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-261-6672
Practice Address - Fax:239-261-6043
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2809213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4558460001OtherDMERC
4558460001Medicare ID - Type Unspecified
T92797Medicare UPIN