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CHARLES SEDILLO MATA CO
NPI 1245438704
Specialist in Crestview, FL

Active since July 06, 2007
4100 S FERDON BLVD, B-4, CRESTVIEW, FL 32536(850) 449-0380 Get Directions Write a Review

NPPES record last updated: November 1, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charles Sedillo Mata Co NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES SEDILLO MATA CO (NPI 1245438704) is an individual specialist in Crestview, Florida, licensed in Florida (ORT157) and active in the NPI registry since July 2007.

NPPES Registry Identity

NPI1245438704
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameCHARLES SEDILLO MATACredential: CO
Location Address4100 S FERDON BLVD, B-4Crestview, FL 32536-5252
Mailing Address1920 E Hatton StPensacola, FL 32503-4842 · (850) 449-0380
Phone(850) 449-0380
Sole ProprietorNo
Enumeration DateJuly 6, 2007
Last NPPES UpdateNovember 1, 2007
✔ NPI 1245438704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ORT157
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.
4100 S FERDON BLVD, Crestview, FL 32536
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Other Identifiers 1

Medicare NSC5941110001FL

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA ANN GIBSON MSN, CNM, ARNP
Advanced Practice Midwife
4100 S FERDON BLVD, SUITE A4
CRESTVIEW, FL 32536
Okaloosa County (850) 398-8940
MR. RANDYN SHAMAR MCMILLAN CO, LDO
Technician/Technologist (Orthoptist)
4100 S FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 204-4762
CABANA EYES OPTICAL
Eyewear Supplier
4100 S FERDON BLVD, SUITE B5
CRESTVIEW, FL 32536
Okaloosa County (850) 758-0474
ALLISON RIVERS
Speech-Language Pathologist
4100 S FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 682-8388
DIANA GIBBS
Physical Therapist
4100 S FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 682-8388
MRS. STACY MARIE TAYLOR
Occupational Therapist
4100 S FERDON BLVD, SUITE C-1
CRESTVIEW, FL 32536
Okaloosa County (850) 682-8388
PRIME THERAPY, INC
Clinic/Center
4100 S FERDON BLVD, STE A1
CRESTVIEW, FL 32536
Okaloosa County (850) 682-8388
DESIRAY LAVON GREER
Behavior Analyst
4100 S FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 362-6824

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Mata's NPI number?

The NPI number for Charles Mata is 1245438704. It was assigned to this individual provider in the NPPES registry on July 6, 2007.

Where is Charles Mata located?

Charles Mata practices at 4100 S Ferdon Blvd B-4, Crestview, FL 32536. The listed phone number is (850) 449-0380.

What is Charles Mata's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Charles Mata was last updated on November 1, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.