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

Lakeland Regional Health System, Inc

Organization Family Medicine Physician · NPI 1215609011

Lakeland Regional Health System, Inc is a Family Medicine Physician in Lake Wales, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5
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

23749 US Highway 27
Lake Wales, FL 33859-7802
Phone: (863) 676-0014
Fax: (863) 687-1494
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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
Orthopaedic Surgery Physician Taxonomy 207X00000X
Surgical Oncology Physician Taxonomy 2086X0206X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1215609011
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Green — Evp/Cfo · (863) 687-1100
NPI enumeratedSeptember 30, 2021
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026
Mailing addressAttn Managed Care Department, 1324 Lakeland Hills Blvd, Lakeland, FL 33805

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