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Individual

BRENT M PENDERGAST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP,CRNA

Contact information

Practice address
4725 N. FEDERAL HWY, FORT LAUDERDALE, FL 33308-4603
(954) 771-8000
Mailing address
2006 HOGBACK RD., SUITE 5A, ANN ARBOR, MI 48105-9750
(734) 263-2414

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11030608
FL
367500000X
Certified Registered Nurse Anesthetist
D184978
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121156300
FL
Enumeration date
12/14/2021
Last updated
07/08/2025
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