# LAKELAND REGIONAL HEALTH SYSTEMS, INC.

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

## Provider details

- **NPI number:** 1669817144
- **Authorized official:** LANCE GREEN (VP CFO)
- **Authorized official phone:** (863) 687-1100

## Contact information

- **Practice address:** 3030 HARDEN BLVD, LAKELAND, FL 33803-7952
- **Practice address phone:** (863) 284-5115
- **Practice address fax:** (863) 413-4739
- **Mailing address:** 1324 LAKELAND HILLS BLVD, MANAGED CARE DEPT, LAKELAND, FL 33805
- **Mailing address phone:** (863) 687-1100
- **Mailing address fax:** (863) 630-6528

## 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 | — | — | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | NULL | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | FL | Yes |

## Other

- **Enumeration date:** 05/09/2013
- **Last updated:** 01/24/2023