Organization
COASTAL CARE CORPORATION
Active
Other names
Cleveland Clinic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization
Contact information
Practice address
10000 SW INNOVATION WAY, PORT SAINT LUCIE, FL 34987-2111
(772) 345-5236
Mailing address
6801 BRECKSVILLE RD, STE 20, RK2-7, INDEPENDENCE, OH 44131
(216) 636-4969
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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