# LAKELAND REGIONAL HEALTH SYSTEMS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114593555
- **Authorized official:** LANCE GREEN (EVP/CFO)
- **Authorized official phone:** (863) 687-1100

## Contact information

- **Practice address:** 300 PARKVIEW PL FL 33805, LAKELAND, FL 33805-4550
- **Practice address phone:** (863) 687-1300
- **Practice address fax:** (863) 687-1305
- **Mailing address:** 1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
- **Mailing address phone:** (863) 687-1100
- **Mailing address fax:** (863) 630-6528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2021
- **Last updated:** 01/04/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 263421018 | — | FL |