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 1619312360

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

Licensed in
FL
In the registry since
2013
Specialties on file
11
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

130 Pablo St
Lakeland, FL 33803-3818
Phone: (863) 284-5941
Fax: (863) 284-5199
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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
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Clinical Cardiac Electrophysiology Physician Taxonomy 207RC0001X
Gastroenterology Physician Taxonomy 207RG0100X
Interventional Cardiology Physician Taxonomy 207RI0011X
Surgery Physician Taxonomy 208600000X
Trauma Surgery Physician Taxonomy 2086S0127X
Urology Physician Taxonomy 208800000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1619312360
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Green — Vp / Cfo · (863) 687-1100
Other names Pablo Campus
NPI enumeratedMay 8, 2013
Last updated in NPPESJanuary 24, 2023
Certification dateJanuary 24, 2023
Mailing addressAttn: Managed Care Department, 1324 Lakleland Hills Blvd, Lakeland, FL 33805-4543

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