Provider Demographics
NPI:1821315979
Name:GRESSER, CHARLES (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:GRESSER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4383 NORTH TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:239-261-6611
Mailing Address - Fax:239-261-4027
Practice Address - Street 1:4383 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3106
Practice Address - Country:US
Practice Address - Phone:239-261-6611
Practice Address - Fax:239-261-4027
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 26211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist