Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Sedillo Mata, CO

Individual provider Specialist · NPI 1245438704

Charles Sedillo Mata, CO is a Specialist in Crestview, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
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Practice location Address checks out

4100 S Ferdon Blvd B-4
Crestview, FL 32536-5252
Phone: (850) 449-0380
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ORT157 (FL)

Record details

NPI number1245438704
Entity typeIndividual (Type 1)
GenderMale
Credentials CO
Sole proprietorNo
NPI enumeratedJuly 6, 2007
Last updated in NPPESNovember 1, 2007

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