Individual
DAVID ANDREW KELLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA, RD
Contact information
Practice address
2343 AARON ST, PORT CHARLOTTE, FL 33952-5305
(855) 979-5700
(855) 979-5701
Mailing address
PO BOX 11126, BELFAST, ME 04915-4002
(877) 856-3774
(239) 599-2612
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DT81736
TX
208M00000X
Hospitalist Physician
PA9120088
FL
363A00000X
Physician Assistant
PA04525
TX
363A00000X
Physician Assistant
Primary
PA9120088
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1G0179
MEDICARE
TX
05
—
355695308
—
TX
Enumeration date
03/28/2007
Last updated
05/06/2026
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