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Organization
COASTAL CARE CORPORATION
Active
Organization
COASTAL CARE CORPORATION
Active
Other names
CLEVELAND CLINIC IMAGING, MARTIN HEALTH DIAGNOSTIC SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
(216) 445-1343
Entity
Organization
Contact information
Practice address
3801 S KANNER HWY STE 102, STUART, FL 34994-4801
(772) 223-4903
(772) 223-5622
Mailing address
6801 BRECKSVILLE RD, STE 20 ATTN: DPC RK2-7, INDEPENDENCE, OH 44131-5062
(216) 636-4969
(216) 636-6063
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
4102
FL
261QR0206X
Mammography Clinic/Center
4102
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA5218
RR MEDICARE
FL
01
—
V2393
BLUE CROSS
FL
Enumeration date
03/15/2006
Last updated
08/08/2025
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