Individual
KELLY D HENCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 898-7451
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 898-7451
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101248475
VA
208000000X
Pediatrics Physician
9701394
NC
208000000X
Pediatrics Physician
Primary
ME162539
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891098F
—
NC
Enumeration date
10/17/2006
Last updated
01/15/2025
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