Provider Demographics
NPI:1174517452
Name:BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Entity type:Organization
Organization Name:BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:407-830-8820
Mailing Address - Street 1:376 NORTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5261
Mailing Address - Country:US
Mailing Address - Phone:407-830-8820
Mailing Address - Fax:800-269-5493
Practice Address - Street 1:376 NORTHLAKE BLVD STE 1008
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5261
Practice Address - Country:US
Practice Address - Phone:888-292-0744
Practice Address - Fax:800-269-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 3336M0002X
FLPH10680332BP3500X, 333600000X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101275400Medicaid
FL101275400Medicaid
FLP5358OtherBLUE CROSS BLUE SHIELD