# COASTAL CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Medical Transport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386663730
- **Authorized official:** DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
- **Authorized official phone:** (216) 445-1343

## Contact information

- **Practice address:** 10050 SW INNOVATION WAY STE 104, PORT SAINT LUCIE, FL 34987-2117
- **Practice address phone:** (772) 223-5793
- **Mailing address:** 6801 BRECKSVILLE RD, STE 20 ATTN: DPC RK2-7, INDEPENDENCE, OH 44131-5062
- **Mailing address phone:** (216) 636-4969
- **Mailing address fax:** (216) 636-6063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 4102 | FL | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 08/08/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 084593100 | — | FL |