MEDICARE: BIOPLUS SPECIALTY PHARMACY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336H0001X	Home Infusion Therapy Pharmacy
2	3336M0002X	Mail Order Pharmacy
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	PH10680	FL
4	333600000X	Pharmacy	PH10680	FL
5	3336S0011X	Specialty Pharmacy	PH10680	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174517452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC

Provider Business Mailing Address
First Line	:	376 NORTHLAKE BLVD
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5261
Country	:	US
Telephone Number	:	407-830-8820
Fax Number	:	800-269-5493

Provider Business Practice Location Address
First Line	:	376 NORTHLAKE BLVD STE 1008
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5261
Country	:	US
Telephone Number	:	888-292-0744
Fax Number	:	800-269-5493

Authorized Official
Title or Position	:	COO
Name	:	DR. ELVIN MONTANEZ
Credential	:	PHARMD
Telephone Number	:	407-830-8820

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	08/19/2022

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