Provider Demographics
NPI:1316422199
Name:SAKYI-AGYEKUM, ANGELIA LYNETTE (PA)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:LYNETTE
Last Name:SAKYI-AGYEKUM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8291 DANI DR STE 101A
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-8009
Mailing Address - Country:US
Mailing Address - Phone:239-931-6049
Mailing Address - Fax:239-931-4986
Practice Address - Street 1:8291 DANI DR
Practice Address - Street 2:STE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-8021
Practice Address - Country:US
Practice Address - Phone:239-931-6049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant