Kellenberger, Edward F
Kellenberger, Edward F is an individual health care provider with primary practice located at 10050 Sw Innovation Way Ste 102 , Port St Lucie FL 34987-2117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Kellenberger, Edward F can be contacted via phone (772) 344-3811.Contact Information
Primary practice address
10050 Sw Innovation Way Ste 102
Port St Lucie FL 34987-2117
Phone: (772) 344-3811
Fax: (772) 335-2422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | ME120630 | Florida |
Profile Details
| NPI number | 1487817904 |
|---|---|
| LBN Legal business name | Kellenberger, Edward F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2008 |
| Last updated | Oct 15th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487817904 | NPPES |
| Florida | MEDICAID | 012834800 | |
| Florida | Other | P01366910 |
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