Provider Demographics
NPI:1679448351
Name:ELIDAN BIOACTIVE COMPOUNDS LLC
Entity type:Organization
Organization Name:ELIDAN BIOACTIVE COMPOUNDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ RODRIGUEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:813-405-5107
Mailing Address - Street 1:8888 CYPRESS MANOR DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3767
Mailing Address - Country:US
Mailing Address - Phone:813-405-5107
Mailing Address - Fax:813-405-5107
Practice Address - Street 1:8888 CYPRESS MANOR DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3767
Practice Address - Country:US
Practice Address - Phone:813-405-5107
Practice Address - Fax:813-405-5107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals