Provider Demographics
NPI:1073549663
Name:NEOGENOMICS LABORATORIES INC
Entity Type:Organization
Organization Name:NEOGENOMICS LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-776-5907
Mailing Address - Street 1:PO BOX 864110
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-4110
Mailing Address - Country:US
Mailing Address - Phone:239-768-0600
Mailing Address - Fax:239-690-4236
Practice Address - Street 1:500 OCEAN DR APT E8C
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1989
Practice Address - Country:US
Practice Address - Phone:866-776-5907
Practice Address - Fax:888-443-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800017185291U00000X
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000354000Medicaid
FL000354000Medicaid