NPIMap

Organization Active NPI

Revive5 Pain Management LLC

  • Pain Clinic/Center
  • Orlando, FL
National Provider Identifier
1508749664
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
REVIVE5 PAIN MANAGEMENT LLC
Practice address
801 N Orange Ave Ste 710
Orlando, FL 32801-5202
Phone
(407) 333-0496
NPI assigned
Jul 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Mr. Osama Soudah
Title
Owner
Phone
(714) 476-6272

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Ambulatory Surgical Clinic/Center 261QA1903X
Multi-Specialty Clinic/Center 261QM1300X
Pain Clinic/Center 261QP3300X Primary
Urgent Care Clinic/Center 261QU0200X
Oncology Clinic/Center 261QX0200X

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": "1753660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1508749664",
    "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": "REVIVE5 PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "SOUDAH",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-476-6272",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 28, 2025; 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.