Provider Demographics
NPI:1841039294
Name:BIOWIK LLC
Entity type:Organization
Organization Name:BIOWIK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CORNELIA
Authorized Official - Middle Name:PAULINA
Authorized Official - Last Name:DETESAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-371-8337
Mailing Address - Street 1:4649 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:786-371-8337
Mailing Address - Fax:
Practice Address - Street 1:4649 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:786-371-8337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty