Organization Active NPI

Pure Renewal Regenerative Concierge Medicine LLC

  • Clinic/Center
  • Orlando, FL
National Provider Identifier
1386503860
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PURE RENEWAL REGENERATIVE CONCIERGE MEDICINE LLC
Practice address
801 N Orange Ave Ste 710
Orlando, FL 32801-5202
Phone
(407) 333-0496
NPI assigned
Jan 20, 2026
Last updated
Jan 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Osama Soudah
Title
MGR
Phone
(714) 476-6272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

801 N Orange Ave Ste 710
Orlando, FL 32801-5202

Mailing address

801 N Orange Ave Ste 710
Orlando, FL 32801-5202
Phone (407) 333-0496

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1386503860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE STE 710",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328015202",
            "telephone_number": "407-333-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE STE 710",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328015202",
            "telephone_number": "407-333-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE RENEWAL REGENERATIVE CONCIERGE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "SOUDAH",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "714-476-6272"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.