Provider Demographics
NPI:1205803111
Name:SUDBURY, AARON MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:MATTHEW
Last Name:SUDBURY
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 1:1767 LAKEWOOD RANCH BLVD # 312
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4906
Mailing Address - Country:US
Mailing Address - Phone:941-745-5115
Mailing Address - Fax:941-567-1000
Practice Address - Street 1:5323 4TH AVENUE CIR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208
Practice Address - Country:US
Practice Address - Phone:941-745-5115
Practice Address - Fax:941-567-1000
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89915207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery