Provider Demographics
NPI:1821309410
Name:SEQUEIRA, CHRISTOPHER ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANGELO
Last Name:SEQUEIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:460 N ORLANDO AVE
Practice Address - Street 2:STE 200 BULG D
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2988
Practice Address - Country:US
Practice Address - Phone:407-898-5452
Practice Address - Fax:407-628-9529
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME132849207RH0000X, 207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009122700Medicaid
FLHJ226ZMedicare PIN