PHOENIX MEDICAL LABORATORY (NPI# 1841280815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841280815 |
| Entity Type | Organization |
| Organization Name | PHOENIX MEDICAL LABORATORY |
| Other Organization Name | PATH LAB FORT MYERS |
| Practice Address |
12701 Commonwealth Dr Suite 6 Fort Myers FL 33913-8626 |
| Practice Telephone | 2397680600 |
| Practice Fax Number | 2397680711 |
| Mailing Telephone | 2397680600 |
| Mailing Fax Number | 2397680711 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2008-05-29 |
| Authorized Official Name | MR. ROBERT P GASPARINI (PRESIDENT) |
| Authorized Official Telephone | 2397680600 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEOGENOMICS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | 8000017185 | FL | Laboratories |
| N | 291U00000X | Clinical Medical Laboratory | CLIA10D1023653 | FL | Laboratories |
| Y | 291U00000X | Clinical Medical Laboratory | 8000019289 | FL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS FL | L9266 | 01 |
| Other Name | Type Code |
|---|---|
| Path Lab Fort Myers | Doing Business As Name - Organization |
| Street Address |
12701 COMMONWEALTH DR SUITE 6 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33913-8626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952598971 | Hong Liu Drum | Pathology | 12701 Commonwealth Dr, Suite 7, Fort Myers, FL 33913-8626 | 2007-10-03 |
| 1427085117 | Fan Yang | Pathology | 12701 Commonwealth Dr, Fort Myers, FL 33913-8626 | 2006-06-27 |
| 1073549663 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 12701 Commonwealth Dr, Suite 9, Fort Myers, FL 33913 | 2006-06-24 |
| 1134107857 | Adrian Padurean Palmer | Pathology | 12701 Commonwealth Dr, Suite 9, Fort Myers, FL 33913 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467079368 | Fq0014 | Clinic/Center | 11930 Fairway Lakes Dr, Ste 103, Fort Myers, FL 33913 | 2020-06-26 |
| 1386272334 | Chrysallis Wellness Center Inc | Counselor | 11932 Faiway Lakes, Fort Myers, FL 33913 | 2020-03-27 |
| 1811459399 | Kelly Christine Reynolds | Student in an Organized Health Care Education/Training Program | 11750 Rosemount Drive, Fort Myers, FL 33913 | 2019-04-03 |
| 1043784432 | Alex Richard Reynolds | Physician Assistant | 2700 Creekside Ln, Suit 101, Fort Myers, FL 33913 | 2019-01-18 |
| 1881196541 | Kara Seanor | Counselor | 12575 Stone Tower Loop, Fort Myers, FL 33913 | 2018-03-08 |
| 1063951515 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 13121 Paul J. Doherty Pkwy, Fort Myers, FL 33913 | 2017-02-16 |
| 1518337492 | Barry K Butler P.a. | Internal Medicine | 10708 Bradbury Way, Fort Myers, FL 33913 | 2015-10-05 |
| 1811322886 | Bernard Timothy Renner | Pharmacist | 10000 Gulf Coast Town Center Drive, Ft. Myers, FL 33913 | 2013-09-10 |
| 1831531979 | Debra Anne Channer | Pharmacist | 12550 Professional Park Drive Unit 1, Walgreens Co., Ft. Myers, FL 33913 | 2013-07-17 |
| 1144572249 | Victoria Sydeco Tayengco-maisog | Pediatrics | 9304 Trieste Drive, Fort Myers, FL 33913 | 2012-10-12 |
| Find all providers in zip 33913 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023511979 | American Oncology Partners, P.a. | Clinical Medical Laboratory | 2848 Center Pointe Drive, 2nd Floor, Fort Myers, FL 33916-9521 | 2018-03-16 |
| 1972912632 | Florida Cancer Specialists & Research Institute, LLC | Clinical Medical Laboratory | 2848 Center Pointe Dr Ste B, Fort Myers, FL 33916-9521 | 2014-08-07 |
| 1316232481 | Florida Cancer Specialists & Research Institute, LLC | Clinical Medical Laboratory | 2848 Center Pointe Dr Unit A, Fort Myers, FL 33916-9521 | 2011-06-16 |
| 1942301197 | Pulmonary Studies Inc | Clinical Medical Laboratory | 6325 Presidential Ct, Suite 2, Fort Myers, FL 33919-3515 | 2006-09-26 |
| 1295782829 | Diagnostic Services Inc | Clinical Medical Laboratory | 12700 Westlinks Dr, Fort Myers, FL 33913-8017 | 2006-05-28 |
| 1417407727 | Clinical Lab Solutions LLC | Clinical Medical Laboratory | 9671 Gladiolus Dr, Suite 102, Fort Myers, FL 33908-7684 | 2016-10-11 |
| 1366803447 | Qr Diagnostics LLC | Clinical Medical Laboratory | 12734 Kenwood Ln, Unit 68, Fort Myers, FL 33907-5666 | 2016-03-16 |
| 1972989424 | Advanced Labs of Sw Florida, LLC | Clinical Medical Laboratory | 6120 Winkler Rd, Suite J, Fort Myers, FL 33919-8125 | 2015-08-07 |
| 1649469453 | Genesiscare Usa of Florida LLC | Clinical Medical Laboratory | 1860 Boy Scout Dr, Suite 203-204, Fort Myers, FL 33907-2144 | 2007-10-17 |
| 1184642142 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 13691 Metro Pkwy, Ste 200, Fort Myers, FL 33912-4321 | 2006-07-18 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33913 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.