NEOVANCE SPECIALTY PHARMACY LLC NPI 1780811125

NPI Information

  • NPI: 1780811125
  • Provider Name: NEOVANCE SPECIALTY PHARMACY LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • :
  • Address: 100 TECHNOLOGY PARK STE 158
    LAKE MARY, FL
    ZIP 32746
  • Phone: (866) 842-2147

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NPI Details

NEOVANCE SPECIALTY PHARMACY LLC is a pharmacy in Lake Mary, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. NEOVANCE SPECIALTY PHARMACY LLC NPI is 1780811125. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

100 TECHNOLOGY PARK STE 158
LAKE MARY, FL
ZIP 32746-205
Phone: (866) 842-2147
Fax: (866) 842-1509

The provider's authorized official is Mary Balaskas .
The authorized official title is Chief Operations Officer and has the following contact phone number (312) 522-9877.

The enumeration date for this NPI number is 6/12/2009 and was last updated on 9/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2333600000XPharmacyPH23883FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12120585OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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