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Organization

PREMIUM ABUNDANT LIFE SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VIRGINIA A. GRIFFITH (ADMINISTRATOR/ OPERATIONS MANAGER)
(813) 932-1240
Entity
Organization

Contact information

Practice address
804 E RICHMERE ST, TAMPA, FL 33612-8044
(813) 932-1240
Mailing address
804 E RICHMERE ST, TAMPA, FL 33612-8044
(813) 932-1240

Taxonomy

Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
230426
FL

Other

Enumeration date
04/14/2008
Last updated
04/14/2008
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