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Organization
COASTAL CARE CORPORATION
Active
Organization
COASTAL CARE CORPORATION
Active
Other names
Cleveland Clinic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization
Contact information
Practice address
10000 SW INNOVATION WAY, PORT SAINT LUCIE, FL 34987-2111
(772) 345-5236
Mailing address
6801 BRECKSVILLE RD, STE 20, RK2-7, INDEPENDENCE, OH 44131
(216) 636-4969
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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