# LAKELAND REGIONAL HEALTH SYSTEMS, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1750124251
- **Authorized official:** LANCE GREEN (EVP/CFO)
- **Authorized official phone:** (863) 687-1100

## Contact information

- **Practice address:** 4729 US HIGHWAY 98 S STE 104, LAKELAND, FL 33812-4323
- **Practice address phone:** (863) 284-1500
- **Practice address fax:** (863) 284-1501
- **Mailing address:** 1324 LAKELAND 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 | — | — | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/13/2024
- **Last updated:** 05/12/2025
