Provider Demographics
NPI:1013232289
Name:SUPLEE, RYAN STARK (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:STARK
Last Name:SUPLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 CATTLEMEN RD STE 206
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6058
Mailing Address - Country:US
Mailing Address - Phone:941-966-4374
Mailing Address - Fax:941-342-3432
Practice Address - Street 1:3333 CATTLEMEN RD STE 206
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6058
Practice Address - Country:US
Practice Address - Phone:941-341-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1249982086S0129X
NY2807202086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery