Individual
GINCY LIZ KANDANKULAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2465 S STATE ROAD 7 STE 800, WELLINGTON, FL 33414-9348
(561) 784-4930
(561) 793-4544
Mailing address
8200 S JOG RD, SUITE 102, BOYNTON BEACH, FL 33472-2981
(561) 784-4930
(561) 784-4931
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
121147
FL
Other
Enumeration date
01/05/2010
Last updated
04/11/2022
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