# PREMISE HEALTH OF FLORIDA MEDICAL, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Wellness Center operated by Premise Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073240321
- **Authorized official:** JON LEIZMAN (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 9300 28TH ST N, PINELLAS PARK, FL 33782-6122
- **Practice address phone:** (727) 578-6940
- **Mailing address:** 5500 MARYLAND FARMS, 120, BRENTWOOD, TN 37027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2022
- **Last updated:** 08/05/2022