# COASTAL CARE CORPORATION

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

## Provider details

- **NPI number:** 1609989391
- **Authorized official:** ROBERT LESTER LORD (PRESIDENT)
- **Authorized official phone:** (772) 223-5945

## Contact information

- **Practice address:** 200 SE HOSPITAL AVE, STUART, FL 34994-2346
- **Practice address phone:** (772) 223-4903
- **Practice address fax:** (772) 223-5622
- **Mailing address:** PO BOX 9033, STUART, FL 34995-9033
- **Mailing address phone:** (772) 223-4903
- **Mailing address fax:** (772) 223-5622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 10/03/2019