Individual
DR. SEBASTIAN DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2415 N. ORANGE AVE, SUITE 400, ORLANDO, FL 32804
(407) 303-7399
(407) 303-7305
Mailing address
2415 N. ORANGE AVE, SUITE 400, ORLANDO, FL 32804
(407) 303-7399
(407) 303-7305
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
117167
NC
208600000X
Surgery Physician
Primary
ME106946
FL
2086X0206X
Surgical Oncology Physician
ME106946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002460700
—
FL
Enumeration date
04/28/2008
Last updated
10/31/2019
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