Healthcare Provider Details

I. General information

NPI: 1194201194
Provider Name (Legal Business Name): RYAN LEE SAPPENFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2018
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3625
US

IV. Provider business mailing address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3625
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2018018348
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME177057
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD93145
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number82143
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: