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General NPI Number Information
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NPI Number | 1003974783
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Entity Type | Individual
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Provider Name | OSVALDO R MORALES DEL CASTILLO M D
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 4048 EVANS AVE SUITE 209
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City | FT MYERS
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State | FL
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Zip | 33901
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Country | US
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Telephone | 239-278-9983
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Fax | 239-278-9985
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Provider Business Mailing Address
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Address Line | 4048 EVANS AVE SUITE 209
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City | FT MYERS
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State | FL
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Zip | 33901
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Country | US
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Telephone | 239-278-9983
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Fax | 239-278-9985
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME57921
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License Number State | FL
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