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COASTAL CARE CORPORATION NPI 1821147059


NPI Information

NPI: 1821147059
Provider Name: COASTAL CARE CORPORATION

Doing Business As: MARTIN MEMORIAL MEDICENTER AT ST LUCIE WEST

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D2299425

Address:
1095 NW SAINT LUCIE WEST BLVD
PORT ST LUCIE, FL
ZIP 34986
Phone: (772) 785-5500
Get Directions

COASTAL CARE CORPORATION is a family medicine in Port St Lucie, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. COASTAL CARE CORPORATION NPI is 1821147059. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Martin Memorial Medicenter At St Lucie West.

The provider's business location address is:

1095 NW SAINT LUCIE WEST BLVD
PORT ST LUCIE, FL
ZIP 34986-719
Phone: (772) 785-5500
Fax: (772) 785-5598

The provider's authorized official is Markey Debbie .
The authorized official title is Manager and has the following contact phone number (772) 785-5510.

The CLIA number assigned to this NPI record is 10D2299425 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 8/27/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine110680041014466FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1064696207MEDICAIDFLORIDA
298491IMEDICARE PINFLORIDA
31142590007MEDICARE NSCFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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