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 Obstetrics & Gynecology Physician · NPI 1487068672

Lakeland Regional Health System, Inc is an Obstetrics & Gynecology Physician in Lakeland, Florida. Licensed in Florida. Registered with an NPI since 2014.

Licensed in
FL
In the registry since
2014
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

1324 Lakeland Hills Blvd Pavillion - OBGYN
Lakeland, FL 33805-4543
Phone: (863) 284-6860
Fax: (863) 688-7959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X (FL)
Obstetrics & Gynecology Nurse Practitioner Taxonomy 363LX0001X
Advanced Practice Midwife Taxonomy 367A00000X

Record details

NPI number1487068672
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Green — Vp / Cfo · (863) 687-1100
Other names Pavillion - Obgyn
NPI enumeratedJune 16, 2014
Last updated in NPPESJanuary 4, 2023
Certification dateDecember 22, 2022
Mailing address1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543

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