Organization
REVIVE5 PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSAMA SOUDAH (OWNER)
(714) 476-6272
Entity
Organization
Contact information
Practice address
801 N ORANGE AVE STE 710, ORLANDO, FL 32801-5202
(407) 333-0496
Mailing address
801 N ORANGE AVE STE 710, ORLANDO, FL 32801-5202
(407) 333-0496
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
261QX0200X
Oncology Clinic/Center
—
—
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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