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General NPI Number Information
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NPI Number | 1578598793
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Entity Type | Organization
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Legal Business Name | COASTAL CARE CORPORATION
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 625 SE RIVERSIDE DR
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City | STUART
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State | FL
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Zip | 34994-2502
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Country | US
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Telephone | 772-221-2002
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Fax | 772-223-5622
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Provider Business Mailing Address
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Address Line | 6801 BRECKSVILLE RD STE 20 ATTN: DPC RK2-7
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City | INDEPENDENCE
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State | OH
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Zip | 44131-5062
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Country | US
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Telephone | 216-636-4969
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Fax | 216-636-6036
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Authorized Official
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Title or Position | EXECUTIVE VP CHIEF FINANCE OFFICER
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Name | MR. DENNIS LARAWAY
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Credential |
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Telephone | 216-445-1343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 4102
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License Number State | FL
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