Provider Demographics
NPI:1437375748
Name:PRATT, COLEMAN SIMS II (MD)
Entity Type:Individual
Prefix:
First Name:COLEMAN
Middle Name:SIMS
Last Name:PRATT
Suffix:II
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 1:5861 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2704
Mailing Address - Country:US
Mailing Address - Phone:941-251-4612
Mailing Address - Fax:941-251-6091
Practice Address - Street 1:5861 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2704
Practice Address - Country:US
Practice Address - Phone:941-725-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP630117713400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME94916OtherMEDICAL LICENSE