Individual provider Active NPI

Osvaldo R Morales del Castillo, M D

  • Pediatrics Physician
  • Ft Myers, FL
National Provider Identifier
1003974783
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME57921 Issued in FL
Practice address
4048 Evans Ave
Suite 209
Ft Myers, FL 33901
Phone
(239) 278-9983
Fax
(239) 278-9985
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME57921 FL Primary

Addresses

Primary practice location

4048 Evans Ave
Suite 209
Ft Myers, FL 33901

Mailing address

4048 Evans Ave
Suite 209
Ft Myers, FL 33901
Phone (239) 278-9983

Other identifiers 1

IdentifierTypeStateIssuer
063212100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME57921FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Centers of Lee Co Pediatrics Past Accepting new patients
Pediatric Centers of Lee County Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1003974783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "SUITE 209",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "239-278-9983",
            "fax_number": "239-278-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "SUITE 209",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "239-278-9983",
            "fax_number": "239-278-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES DEL CASTILLO",
        "first_name": "OSVALDO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME57921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063212100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.