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Individual

BRENDAN MICHAEL PRENDERGAST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8725 N WICKHAM RD, MELBOURNE, FL 32940-2239
(321) 253-4673
(321) 253-4338
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 253-4673

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME115355
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010168900
FL
01
HI443Y
HFMG MEDICARE
FL
01
P01593508
FL RR MEDICARE
FL
Enumeration date
04/11/2008
Last updated
12/05/2024
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