MEDICARE: LTR MEDICAL MANAGEMENT GROUP INC

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	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1972555316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LTR MEDICAL MANAGEMENT GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 55065
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-0065
Country	:	US
Telephone Number	:	904-727-7733
Fax Number	:	904-727-7737

Provider Business Practice Location Address
First Line	:	3101 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2750
Country	:	US
Telephone Number	:	904-727-7733
Fax Number	:	904-727-7737

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JANET L STEPHENS
Credential	:
Telephone Number	:	904-727-7733

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1720606361 — MRS. KRYSTAL HENLEY VAUGHN FNP
Practice Location Address:

3101 UNIVERSITY BLVD S STE 102
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-737-1171
Practice Fax: 904-721-4022

1639156276 — DARLENE BARTILUCCI MD
Practice Location Address:

3101 UNIVERSITY BLVD S STE 102
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-737-1171
Practice Fax: 904-721-4022

1669449229 — DR. KENNETH R MAYER MD
Practice Location Address:

3101 UNIVERSITY BLVD S STE 102 , CREDENTIALING DEPARTMENT
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-737-1171
Practice Fax: 904-721-4022

1932125291 — DR. JAMES A GRAHAM M.D.
Practice Location Address:

3101 UNIVERSITY BLVD S STE 102
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-737-1171
Practice Fax: 904-721-4022

1437266178 — DR. BRYAN T ORONSKY M.D.
Practice Location Address:

3101 UNIVERSITY BLVD. S , SUITE 100
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-727-7733
Practice Fax: 904-727-7737

1205915014 — DR. DENISE C GINART M.D.
Practice Location Address:

3101 UNIVERSITY BLVD S STE 102 , CREDENTIALING DEPARTMENT
JACKSONVILLE, FL
32216-2750

Practice Phone: 904-737-1171
Practice Fax: 904-739-8022

Directions to “LTR MEDICAL MANAGEMENT GROUP INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.