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Individual

DR. JASON-ANTHONY KIRKHAM PRENDERGAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1451 W CYPRESS CREEK RD, FORT LAUDERDALE, FL 33309-1961
(888) 773-3439
Mailing address
4163 NW 48TH AVE, LAUDERDALE LAKES, FL 33319-4716
(954) 383-3776

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
17769
FL

Other

Enumeration date
03/16/2018
Last updated
03/16/2018
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