Healthcare Provider Details

I. General information

NPI: 1417271578
Provider Name (Legal Business Name): COASTAL ORTHOPAEDICS & SPORTS MEDICINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 SE OCEAN BLVD STE 200
STUART FL
34996-3341
US

IV. Provider business mailing address

7710 S US HIGHWAY 1
PORT SAINT LUCIE FL
34952-2320
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-5500
  • Fax: 772-200-2131
Mailing address:
  • Phone: 772-335-5300
  • Fax: 772-878-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD JESUS ROSSARIO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-335-5300