# MARTIN MEMORIAL PHYSICIAN CORPORATION INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578505228
- **Authorized official:** DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
- **Authorized official phone:** (216) 445-1343

## Contact information

- **Practice address:** 200 SE HOSPITAL AVE, STUART, FL 34994-2346
- **Practice address phone:** (772) 223-2832
- **Practice address fax:** (772) 781-2716
- **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 |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 208D00000X | General Practice Physician | — | FL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 08/08/2025