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General NPI Number Information
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NPI Number | 1073632410
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Entity Type | Individual
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Provider Name | DAVID ANDREW KELLENBERGER PA, RD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 2343 AARON ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5305
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Country | US
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Telephone | 855-979-5700
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Fax | 855-979-5701
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Provider Business Mailing Address
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Address Line | PO BOX 11126
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City | BELFAST
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State | ME
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Zip | 04915-4002
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Country | US
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Telephone | 877-856-3774
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Fax | 239-599-2612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA04525
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT81736
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License Number State | TX
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