Provider Demographics
NPI:1457780363
Name:SEBASTIAN, CARMELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMELLA
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12912 CASTLEMAINE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4470
Mailing Address - Country:US
Mailing Address - Phone:813-480-3294
Mailing Address - Fax:
Practice Address - Street 1:12912 CASTLEMAINE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4470
Practice Address - Country:US
Practice Address - Phone:813-480-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine