| Coastal Care Corporation | |
|
1095 Nw Saint Lucie West Blvd Port St Lucie FL 34986-1719 | |
| (772) 785-5500 | |
| (772) 785-5598 |
| Full Name | Coastal Care Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1095 Nw Saint Lucie West Blvd, Port St Lucie, Florida |
| Authorized Official Name and Position | Markey Debbie (MANAGER) |
| Authorized Official Contact | 7727855510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Care Corporation Po Box 417 Stuart FL 34995-0417 Ph: (772) 223-5665 | Coastal Care Corporation 1095 Nw Saint Lucie West Blvd Port St Lucie FL 34986-1719 Ph: (772) 785-5500 |
| NPI Number | 1821147059 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821147059 | NPI | - | NPPES |
| 064696207 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 110680041014466 (Florida) | Primary |
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