| Doctor Name: | DR. MAURICIO JOSE DE CASTRO |
| NPI Number: | 1407083256 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101250567 |
| Business Practice Address: | 301 Fisher St Room Gg 700 Keesler Afb, MS - 395342508 |
| Business Phone Number: | 2283763389 |
| Business Fax Number: | |
| Mailing Address: | 301 Fisher St, Room Gg 700 KEESLER AFB |
| State: | MS |
| Postal Code: | 395342508 |
| Phone Number: | 2283763389 |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2009 |
| NPI Last Update Date: | 10/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207SG0203X |
| License Number: | 0101250567 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Medical Genetics |
| Taxonomy Specialization: | Clinical Molecular Genetics |
| Taxonomy Definition: | A clinical molecular geneticist demonstrates competence in performing and interpreting molecular analyses relevant to the diagnosis and management of human genetic diseases and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders. |