Provider Demographics
NPI:1336588565
Name:OKSANA BUTTITA DPM PLLC
Entity Type:Organization
Organization Name:OKSANA BUTTITA DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTITA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-814-5514
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE # 203
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4834
Mailing Address - Country:US
Mailing Address - Phone:305-814-5514
Mailing Address - Fax:754-263-2394
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE # 203
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4834
Practice Address - Country:US
Practice Address - Phone:305-814-5514
Practice Address - Fax:305-731-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3559213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008948000Medicaid
FLHN673AMedicare PIN