Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Other names
Pablo Campus
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GREEN (VP / CFO)
(863) 687-1100
Entity
Organization
Contact information
Practice address
130 PABLO ST, LAKELAND, FL 33803-3818
(863) 284-5941
(863) 284-5199
Mailing address
ATTN: MANAGED CARE DEPARTMENT, 1324 LAKLELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263421006
—
FL
Enumeration date
05/08/2013
Last updated
01/24/2023
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