MEDICARE: DR. PORUR E. SOMASUNDARAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME143717	FL
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	44397	MN
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	6839195-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689624728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PORUR E. SOMASUNDARAM MD

Provider Business Mailing Address
First Line	:	18669 TAMIAMI TRL
Second Line	:	STE B
City	:	NORTH PORT
State	:	FL
Zip	:	34287
Country	:	US
Telephone Number	:	941-423-5040
Fax Number	:	941-423-5042

Provider Business Practice Location Address
First Line	:	18659 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7388
Country	:	US
Telephone Number	:	941-423-5035
Fax Number	:	941-423-5034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/10/2026

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Directions to “ DR. PORUR E. SOMASUNDARAM MD” Practice Location

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