Provider Demographics
NPI:1841217890
Name:BIOPHARM, INC.
Entity Type:Organization
Organization Name:BIOPHARM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIRENA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-631-1031
Mailing Address - Street 1:701 SW 27TH AVE
Mailing Address - Street 2:SUITE 960
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3031
Mailing Address - Country:US
Mailing Address - Phone:305-631-1031
Mailing Address - Fax:305-595-9904
Practice Address - Street 1:701 SW 27TH AVE
Practice Address - Street 2:SUITE 960
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3031
Practice Address - Country:US
Practice Address - Phone:305-631-1031
Practice Address - Fax:305-595-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH218563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH21856OtherPHARMACY LICENSE NUMBER
FL1018123OtherNCPDP