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General NPI Number Information
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NPI Number | 1578432449
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Entity Type | Organization
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Legal Business Name | ELIDAN BIOACTIVE COMPOUNDS LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 8888 CYPRESS MANOR DR
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City | TAMPA
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State | FL
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Zip | 33647-3767
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Country | US
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Telephone | 786-339-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 8888 CYPRESS MANOR DR
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City | TAMPA
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State | FL
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Zip | 33647-3767
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Country | US
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Telephone | 786-339-4515
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LUIS CRUZ RODRIGUEZ
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Credential | PRESIDENT
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Telephone | 813-405-5107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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