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General NPI Number Information
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NPI Number | 1265876205
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Entity Type | Individual
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Provider Name | GERALD ROACH PADGETT LMT
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Gender | Male
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 204 W UNIVERSITY AVE STE 5
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City | GAINESVILLE
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State | FL
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Zip | 32601-5205
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Country | US
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Telephone | 352-672-8168
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 SW 8TH AVE APT U133
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City | GAINESVILLE
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State | FL
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Zip | 32607-1888
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Country | US
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Telephone | 352-672-8168
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA72303
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License Number State | FL
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