Provider Demographics
NPI:1447591615
Name:SESSLER, CARLOS (AP, LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:SESSLER
Suffix:
Gender:M
Credentials:AP, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 NW 28TH LN
Mailing Address - Street 2:4
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7432
Mailing Address - Country:US
Mailing Address - Phone:305-586-2998
Mailing Address - Fax:
Practice Address - Street 1:4131 NW 28TH LN
Practice Address - Street 2:4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7432
Practice Address - Country:US
Practice Address - Phone:305-586-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3250171100000X
FLMA 51374225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC00NXOtherBLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.