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NPI Code Detail

MEDICARE: DR. BRANDON LEE PRENDES M.D.

MEDICARE: DR. BRANDON LEE PRENDES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207YS0123XFacial Plastic Surgery Physician35.123814OH

General Provider Information

NPI Number : 1528395852
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRANDON LEE PRENDES M.D.
Provider Business Mailing Address
First Line : 9500 EUCLID AVE # DESKA71
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-0578
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE # DESKA71
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-1714
Country : US
Telephone Number : 216-444-0578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2009
Last Update Date : 04/24/2025

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