MEDICARE: LAKELAND REGIONAL HEALTH SYSTEMS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	2084N0400X	Neurology Physician
3	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1801783782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKELAND REGIONAL HEALTH SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	1324 LAKELAND HILLS BLVD.
Second Line	:	ATTN: MANAGED CARE
City	:	LAKELAND
State	:	FL
Zip	:	33805-4543
Country	:	US
Telephone Number	:	863-687-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 AVENUE A SE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-6301
Country	:	US
Telephone Number	:	863-293-2107
Fax Number	:

Authorized Official
Title or Position	:	SVP/CFO
Name	:	LANCE GREEN
Credential	:
Telephone Number	:	863-687-1100

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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