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NPI Code Detail

MEDICARE: LAKELAND REGIONAL MEDICAL CENTER, INC.

MEDICARE: LAKELAND REGIONAL MEDICAL CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2273R00000XPsychiatric Hospital Unit4413FL
3273Y00000XRehabilitation Hospital Unit4413FL
4282N00000XGeneral Acute Care Hospital4413FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144228446
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKELAND REGIONAL MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line : 1324 LAKELAND HILLS BLVD
City : LAKELAND
State : FL
Zip : 33805-4543
Country : US
Telephone Number : 863-687-1100
Fax Number : 863-687-1473
Provider Business Practice Location Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line : MANAGED CARE DEPT
City : LAKELAND
State : FL
Zip : 33805-4543
Country : US
Telephone Number : 863-687-1100
Fax Number : 863-687-1473
Authorized Official
Title or Position : CFO
Name : LANCE GREEN
Credential :
Telephone Number : 863-687-1100
Provider Enumeration Date : 07/11/2005
Last Update Date : 10/31/2023

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Practice Location Address:
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Practice Fax:
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1962491167 — DR. JOSEPH ALBERT NINKE MD
Practice Location Address:
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Directions to “LAKELAND REGIONAL MEDICAL CENTER, INC. ” Practice Location

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