Healthcare Provider Details

I. General information

NPI: 1255662797
Provider Name (Legal Business Name): SARA PUTNAM SIMMONS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 SR 64 E
BRADENTON FL
34212
US

IV. Provider business mailing address

8000 SR 64 E
BRADENTON FL
34212
US

V. Phone/Fax

Practice location:
  • Phone: 941-792-1404
  • Fax: 941-761-0712
Mailing address:
  • Phone: 941-792-1404
  • Fax: 941-761-0712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberME113187
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME113187
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: