Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Other names
Gateway Campus
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GREEN (CFO)
(863) 687-1100
Entity
Organization
Contact information
Practice address
2815 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2224
(863) 284-6900
(863) 284-6904
Mailing address
1324 LAKELAND HILLS BLVD, MANAGED CARE DEPT, LAKELAND, FL 33805
(863) 687-1100
(863) 630-6528
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263421008
—
FL
Enumeration date
05/09/2013
Last updated
01/04/2023
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