Prodigee Investment Group LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

PRODIGEE INVESTMENT GROUP LLC

Practice address

3504 N 10TH St
Tampa, FL 33605-1040

Phone

(813) 777-1263

NPI assigned

Mar 12, 2020

Organization subpart

No

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

Authorized official

Name

Christopher David Warren, MBA

Title

Owner

Phone

(813) 777-1263

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1902431794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 CLEWIS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336107335",
            "telephone_number": "813-620-6262",
            "fax_number": "813-535-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 N 10TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336051040",
            "telephone_number": "813-777-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGEE INVESTMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-777-1263",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary W. Procop, MD
• Zoe E Proctor-Weber, PH.D.
• Candice Proctor
• Cynthia Proctor
• Adam Procuniar, CRNA
• Prodigy Health LLC
• Anet Proenza, APRN
• Professional Behavioral Services, Inc
• Professional Portable Radiologic Services Inc. (Professional Portable X-ray inc.)
• Professional Portable Radiologic Services Inc. (Dynamic Mobile Imaging)

• Developmental Disabilities Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.