Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME57921 | FL |
NPI | 1003974783 |
---|---|
Provider Name | Dr. Osvaldo R Morales Del Castillo |
First Address | Ft Myers, FL 33901 |
Second Address | Ft Myers, FL 33901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 30/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063212100 | (05) | FL |
F25118 | (02) |