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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHARLES SEDILLO MATA, CO

Active

CHARLES SEDILLO MATA, CO is a Specialist healthcare provider located in CRESTVIEW, Florida. NPI 1245438704 is currently active in the NPPES registry. Verify at CMS.

Specialist · CRESTVIEW, FL

Registration Details

NPI Number
1245438704
Provider Type
Individual
Gender
Male
NPI Issued
Jul 6, 2007 (19.134157079991 yrs)
Last Updated
Nov 1, 2007
License
ORT157 (FL)

Practice Information

Address
4100 S FERDON BLVD
B-4
CRESTVIEW, FL, 325365252
Browse FL providers · Browse ZIP 32536
Phone
8504490380
Primary Specialty
Specialist
174400000X

Other Specialist Providers in CRESTVIEW, FL

Name Credential NPI
ALFRED CARDET MD 1770572745
MR. SHIJUN PAN M.D. 1245280858
MR. JOHN DALE CARLSON MD 1932131596
MARIA RODRIGUEZ 1811250749
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.