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General NPI Number Information
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NPI Number | 1962955765
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Entity Type | Organization
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Legal Business Name | OMNI PAIN CARE, LLC
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 3140 S FALKENBURG RD SUITE 205
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City | RIVERVIEW
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State | FL
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Zip | 33578-2574
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Country | US
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Telephone | 813-533-5522
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Fax | 813-533-5511
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Provider Business Mailing Address
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Address Line | 3140 S FALKENBURG RD STE 205
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City | RIVERVIEW
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State | FL
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Zip | 33578-2594
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Country | US
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Telephone | 813-533-5522
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Fax | 813-533-5511
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | DR. SIDHARTH PANCHAMIA
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Credential | M.D.
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Telephone | 813-533-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME106682
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License Number State | FL
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