Organization
COASTAL CARE CORPORATION
Active
Other names
MARTIN MEMORIAL MEDICENTER OF PALM CITY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LESTER LORD (PRESIDENT)
(772) 223-5945
Entity
Organization
Contact information
Practice address
3066 SW MARTIN DOWNS BLVD, UNIT 6 STE B, PALM CITY, FL 34990-2683
(772) 781-2781
(772) 781-2782
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 223-5646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1998122013
FL
261QU0200X
Urgent Care Clinic/Center
Primary
1998122013
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064696203
—
FL
Enumeration date
01/08/2007
Last updated
10/03/2019
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