# COASTAL CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARTIN MEMORIAL MEDICENTER OF PALM CITY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568510618
- **Authorized official:** ROBERT LESTER LORD (PRESIDENT)
- **Authorized official phone:** (772) 223-5945

## Contact information

- **Practice address:** 3066 SW MARTIN DOWNS BLVD, UNIT 6 STE B, PALM CITY, FL 34990-2683
- **Practice address phone:** (772) 781-2781
- **Practice address fax:** (772) 781-2782
- **Mailing address:** PO BOX 417, STUART, FL 34995-0417
- **Mailing address phone:** (772) 223-2832
- **Mailing address fax:** (772) 223-5646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1998122013 | FL | — |
| 261QU0200X | Urgent Care Clinic/Center | 1998122013 | FL | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 10/03/2019