Premium Abundant Life Services LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

230426 Issued in FL

Legal business name

PREMIUM ABUNDANT LIFE SERVICES LLC

Practice address

804 E Richmere St
Tampa, FL 33612-8044

Phone

(813) 932-1240

NPI assigned

Apr 14, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Virginia A. Griffith

Title

Administrator/ Operations Manager

Phone

(813) 932-1240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1245404094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 E RICHMERE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336128044",
            "telephone_number": "813-932-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E RICHMERE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336128044",
            "telephone_number": "813-932-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM ABUNDANT LIFE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR/ OPERATIONS MANAGER",
        "authorized_official_telephone_number": "813-932-1240",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "FL",
            "license": "230426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Florida Medical PA (Capital One Be Well Health Center at Tampa)
• Premise Health of Florida Medical PA (Humana Health & Well-being Center)
• Premise Health of Florida Medical PA (USAA Health Services)
• Premise Health of Florida Medical PA (Live Well at Citi - Tampa)
• Premise Health of Florida Medical PA (USAA Crosstown)
• Paola Premuda Conti, PH.D., CRC, CVE
• Anthony Vincent Prencipe, PHARMD
• Dolores Frey Prendergast, MS, RD, LD/N
• Barbara Teresa Prendes, ARNP
• Caroline Prengaman, PA-C

• Supports Brokerage Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Supports Brokerage Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.