# LAKELAND REGIONAL HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215609011
- **Authorized official:** LANCE GREEN EVP/CFO (EVP/CFO)
- **Authorized official phone:** (863) 687-1100

## Contact information

- **Practice address:** 23749 US HIGHWAY 27, LAKE WALES, FL 33859-7802
- **Practice address phone:** (863) 676-0014
- **Practice address fax:** (863) 687-1494
- **Mailing address:** ATTN MANAGED CARE DEPARTMENT, 1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805
- **Mailing address phone:** (863) 687-1100
- **Mailing address fax:** (863) 284-6825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 2086X0206X | Surgical Oncology Physician | — | NULL | — |
| 2086X0206X | Surgical Oncology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/30/2021
- **Last updated:** 06/09/2026