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General NPI Number Information
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NPI Number | 1801783782
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Entity Type | Organization
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Legal Business Name | LAKELAND REGIONAL HEALTH SYSTEMS, INC.
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 180 AVENUE A SE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-6301
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Country | US
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Telephone | 863-293-2107
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 LAKELAND HILLS BLVD. ATTN: MANAGED CARE
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City | LAKELAND
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State | FL
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Zip | 33805-4543
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Country | US
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Telephone | 863-687-1100
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Fax |
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Authorized Official
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Title or Position | SVP/CFO
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Name | LANCE GREEN
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Credential |
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Telephone | 863-687-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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