# LAKELAND REGIONAL HEALTH SYSTEMS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pablo Campus
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619312360
- **Authorized official:** LANCE GREEN (VP / CFO)
- **Authorized official phone:** (863) 687-1100

## Contact information

- **Practice address:** 130 PABLO ST, LAKELAND, FL 33803-3818
- **Practice address phone:** (863) 284-5941
- **Practice address fax:** (863) 284-5199
- **Mailing address:** ATTN: MANAGED CARE DEPARTMENT, 1324 LAKLELAND HILLS BLVD, LAKELAND, FL 33805-4543
- **Mailing address phone:** (863) 687-1100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0127X | Trauma Surgery Physician | — | NULL | — |
| 2086S0127X | Trauma Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | FL | Yes |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 01/24/2023