Provider Demographics
NPI:1841361144
Name:KANKAM, CYGETHIA GAYLE (MD)
Entity type:Individual
Prefix:DR
First Name:CYGETHIA
Middle Name:GAYLE
Last Name:KANKAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2015 OCEAN DR STE 11
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5131
Mailing Address - Country:US
Mailing Address - Phone:561-364-8056
Mailing Address - Fax:561-364-8507
Practice Address - Street 1:2015 OCEAN DR STE 11
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5131
Practice Address - Country:US
Practice Address - Phone:561-364-8056
Practice Address - Fax:561-364-8507
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG76164Medicare UPIN
FL42708XMedicare PIN