LAKELAND REGIONAL HEALTH SYSTEM INC NPI 1215609011

NPI Information

  • NPI: 1215609011
  • Provider Name: LAKELAND REGIONAL HEALTH SYSTEM, INC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Address: 455 EMERALD AVE
    LAKE WALES, FL
    ZIP 33853
  • Phone: (863) 676-0014

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NPI Details

LAKELAND REGIONAL HEALTH SYSTEM, INC is a multi-specialty clinic center in Lake Wales, FL. LAKELAND REGIONAL HEALTH SYSTEM, INC NPI is 1215609011. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

455 EMERALD AVE
LAKE WALES, FL
ZIP 33853-716
Phone: (863) 676-0014
Fax: (863) 284-6825

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

The enumeration date for this NPI number is 9/30/2021 and was last updated on 4/5/2024.

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
2207X00000XOrthopaedic SurgeryNo
32086X0206XSurgerySurgical OncologyNo
4208D00000XGeneral PracticeNo
5261QM1300XClinic/CenterMulti-SpecialtyYes

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
1263421021MEDICAIDFLORIDA

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: 3/30/2025

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