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Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GREEN (VP, CFO)
(863) 687-1100
Entity
Organization
Contact information
Practice address
430 E CENTRAL AVE, WINTER HAVEN, FL 33880-3050
(863) 284-6850
(863) 284-6853
Mailing address
1324 LAKELAND HILLS BLVD, MANAGED CARE DEPT, LAKELAND, FL 33805
(863) 687-1100
(863) 630-6528
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
FL
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
05/10/2013
Last updated
01/04/2023
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