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Search › Florida › 174400000X

Charles Mata, CO

NPI 1245438704 · on the registry since 2007

Practice

Address
4100 S Ferdon Blvd
B-4
Crestview, FL 32536
Phone
(850) 449-0380
Organisation at this address
Triple E Ot Inc
Prime Therapy, Inc
Cabana Eyes Optical
Kids Talk Place Llc
Michelle H Stevens Md Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address
35

Registry record

Primary taxonomy
174400000X
174400000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-11-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida