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LAKELAND REGIONAL HEALTH SYSTEMS INC. NPI 1083095129


NPI Information

NPI: 1083095129
Provider Name: LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 10D2216669

Address:
208 MAIN ST
AUBURNDALE, FL
ZIP 33823
Phone: (863) 687-1100
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LAKELAND REGIONAL HEALTH SYSTEMS, INC. is a general practice in Auburndale, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LAKELAND REGIONAL HEALTH SYSTEMS, INC. NPI is 1083095129. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

208 MAIN ST
AUBURNDALE, FL
ZIP 33823-404
Phone: (863) 687-1100

The provider's authorized official is Lance Green .
The authorized official title is Vp / Cfo and has the following contact phone number (863) 687-1100.

The CLIA number assigned to this NPI record is 10D2216669 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/15/2015 and was last updated on 1/4/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QM1300XClinic/CenterMulti-SpecialtyNo
3363A00000XPhysician AssistantNo
4208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1263421014MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.