Organization
COASTAL CARE CORPORATION
Active
Other names
MARTIN MEMORIAL MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
(216) 445-1343
Entity
Organization
Contact information
Practice address
625 SE RIVERSIDE DR, STUART, FL 34994-2502
(772) 221-2002
(772) 223-5622
Mailing address
6801 BRECKSVILLE RD, STE 20 ATTN: DPC RK2-7, INDEPENDENCE, OH 44131-5062
(216) 636-4969
(216) 636-6036
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
4102
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA5218
RR MEDICARE
FL
Enumeration date
07/12/2006
Last updated
08/08/2025
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