Individual
MS. DEBORAH C PENDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
655 W 8TH ST, UFJP FAMILY PRACTICE, JACKSONVILLE, FL 32209-6511
(904) 244-3193
(904) 244-5511
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1784
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219840818B
—
GA
05
—
219840818C
—
GA
05
—
2906830-00
—
FL
Enumeration date
03/31/2006
Last updated
08/02/2013
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