Healthcare Provider Details

I. General information

NPI: 1073549663
Provider Name (Legal Business Name): NEOGENOMICS LABORATORIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 OCEAN DR APT 504
JUNO BEACH FL
33408-1723
US

IV. Provider business mailing address

PO BOX 864110
ORLANDO FL
32886-4110
US

V. Phone/Fax

Practice location:
  • Phone: 866-776-5907
  • Fax: 888-443-4513
Mailing address:
  • Phone: 239-768-0600
  • Fax: 239-690-4236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number800017185
License Number StateFL

VIII. Authorized Official

Name: JEFFREY SCOTT SHERMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 866-776-5907