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Charles Sedillo Mata, CO
Specialist in Crestview, Florida
NPI 1245438704

Charles Sedillo Mata is a Specialist based in Pensacola, FL. Charles Sedillo Mata practices in Crestview, FL and has the professional credentials of CO. The NPI Number for Charles Sedillo Mata is 1245438704 and holds a License No. ORT157 (Florida).

The current practice location address for Charles Sedillo Mata is 4100 S Ferdon Blvd, Crestview, FL and can be reached out via phone at 850-449-0380.

Location: 4100 S Ferdon Blvd, Crestview, FL, 32503-4842
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245438704
Provider Name
Charles Sedillo Mata
Credential
CO
Provider Entity Type
Individual
Gender
Male
Address
4100 S Ferdon Blvd, Crestview, FL, 32503-4842
Phone Number
850-449-0380
Fax Number
Provider Enumeration Date
07/06/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4100 S Ferdon Blvd
City
Crestview
State
Florida
Zip
32536-5252
Phone Number
850-449-0380
Fax Number
person
Provider Business Mailing Address Details
Address
4100 S Ferdon Blvd
City
Crestview
State
Florida
Zip
32536-5252
Phone Number
850-449-0380
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ORT157 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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