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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 (EVP/CFO)
(863) 687-1100
Entity
Organization
Contact information
Practice address
1525 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3203
(863) 511-2140
(863) 413-8518
Mailing address
1324 LAKELAND HILLS BLVD, MANAGED CARE DEPT, LAKELAND, FL 33805
(863) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
—
NULL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263421020
—
FL
Enumeration date
10/07/2021
Last updated
01/04/2023
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