| Entity Name: | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Active |
| Date Filed: | 15 Jan 1912 (113 years ago) |
| Document Number: | 800346 |
| FEI/EIN Number | 620331200 |
| Address: | 1 FOUNTAIN SQUARE, CHATTANOOGA, TN, 37402 |
| Mail Address: | 1 FOUNTAIN SQUARE, CHATTANOOGA, TN, 37402 |
| Place of Formation: | TENNESSEE |
| Name | Role | Address |
|---|---|---|
| CHIEF FINANCIAL OFFICER | Agent | P O BOX 6200 (32314-6200), TALLAHASSEE, FL, 323990000 |
| Name | Role | Address |
|---|---|---|
| Katz Benjamin S | Vice President | 1 Fountain Square, Chattanooga, TN, 37402 |
| JULLIENNE JEAN P | Vice President | 1 FOUNTAIN SQUARE, CHATTANOOGA, TN, 37402 |
| Carter Scott P | Vice President | 2211 Congress Street, Portland, ME, 04122 |
| Name | Role | Address |
|---|---|---|
| IGLESIAS LISA G | Director | 1 FOUNTAIN SQ, CHATTANOOGA, TN, 37402 |
| Bhasin Puneet | Director | 1 Fountain Square, Chattanooga, TN, 37402 |
| Zabel Steven A | Director | 1 Fountain Square, Chattanooga, TN, 37402 |
| Name | Role | Address |
|---|---|---|
| Carter Scott P | Secretary | 2211 Congress Street, Portland, ME, 04122 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 1986-05-21 | No data | No data |
| AMENDMENT | 1984-06-06 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
