Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 280720 | NY |
Y | 2086S0129X | Vascular Surgeon | ME124998 | FL |
NPI | 1013232289 |
---|---|
Provider Name | Ryan Stark Suplee |
First Address | Sarasota, FL 34232-6058 |
Second Address | Sarasota, FL 34232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 07/05/2020 |