Healthcare Provider Details

I. General information

NPI: 1982541470
Provider Name (Legal Business Name): CHARLES EDWARD MASSEY RPT, CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSHUA EDWARD STILES RPT, CPHT

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 GALE LEMERAND DR RM 1527
GAINESVILLE FL
32610-3008
US

IV. Provider business mailing address

1549 GALE LEMERAND DR RM 1527
GAINESVILLE FL
32610-3008
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-9368
  • Fax: 352-627-4815
Mailing address:
  • Phone: 352-265-9368
  • Fax: 352-627-4815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberRPT64261
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: