CHARLES MATA, CO
Specialist
Active
Individual
NPI: 1245438704
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Specialist | 174400000X | Yes | ORT157 (FL) |
Frequently Asked Questions
NPI 1245438704 is the National Provider Identifier for CHARLES MATA, CO, a Specialist provider located in Crestview, FL. This NPI was enumerated on July 6, 2007.
CHARLES MATA, CO practices at 4100 S FERDON BLVD, B-4, Crestview, FL 32536.
Quick Facts
- NPI
- 1245438704
- Type
- Individual
- Enumerated
- Jul 6, 2007
- Last Updated
- Nov 1, 2007
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