Healthcare Provider Details

I. General information

NPI: 1205803111
Provider Name (Legal Business Name): AARON MATTHEW SUDBURY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 4TH AVENUE CIR E
BRADENTON FL
34208
US

IV. Provider business mailing address

1767 LAKEWOOD RANCH BLVD # 312
BRADENTON FL
34211-4906
US

V. Phone/Fax

Practice location:
  • Phone: 941-745-5115
  • Fax: 941-567-1000
Mailing address:
  • Phone: 941-745-5115
  • Fax: 941-567-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME89915
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME89915
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: