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

Lakeland Regional Health Systems, Inc

Organization Family Medicine Physician · NPI 1053757526

Lakeland Regional Health Systems, Inc is a Family Medicine Physician in Winter Haven, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
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

430 E Central Ave
Winter Haven, FL 33880-3050
Phone: (863) 284-6850
Fax: (863) 284-6853
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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 (FL)
Family Medicine Physician Taxonomy 207Q00000X
Pediatrics Physician Taxonomy 208000000X
General Practice Physician Taxonomy 208D00000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1053757526
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Green — Vp, Cfo · (863) 687-1100
NPI enumeratedMay 10, 2013
Last updated in NPPESJanuary 4, 2023
Certification dateJanuary 4, 2023
Mailing address1324 Lakeland Hills Blvd, Managed Care Dept, Lakeland, FL 33805

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