MEDICARE: TIMOTHY LAMON STERNBERG M.D., D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	ME69375	FL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME69375	FL
3	208VP0014X	Interventional Pain Medicine Physician	ME69375	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00071130	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669433801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY LAMON STERNBERG M.D., D.M.D.

Provider Business Mailing Address
First Line	:	705 WELLS RD STE 300
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2982
Country	:	US
Telephone Number	:	904-282-6331
Fax Number	:	904-619-1080

Provider Business Practice Location Address
First Line	:	2700 RIVERSIDE AVE STE 2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-8233
Country	:	US
Telephone Number	:	904-264-8801
Fax Number	:	904-621-0566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	09/15/2022

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