Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeland Regional Health System, Inc

Organization Family Medicine Physician · NPI 1093653321

Lakeland Regional Health System, Inc is a Family Medicine Physician in Lakeland, Florida. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4406 S Florida Ave Ste 17
Lakeland, FL 33813-2182
Phone: (863) 646-5088
Fax: (863) 904-4701
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Family Medicine Physician Taxonomy 207Q00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1093653321
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Green — Evp/Cfo · (863) 687-1100
NPI enumeratedMarch 25, 2026
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing address1324 Lakeland Hills Blvd, Attn: Managed Care, Lakeland, FL 33805-4543

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