NPIMap

Organization Active NPI

Coastal Care Corporation

Doing business as Martin Memorial Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Stuart, FL
National Provider Identifier
1316966336
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
904 Issued in FL
Legal business name
COASTAL CARE CORPORATION
Doing business as
Martin Memorial Surgery Center
Practice address
509 SE Riverside Dr
Stuart, FL 34994-2579
Phone
(772) 223-4903
Fax
(772) 223-5622
NPI assigned
Jul 19, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark R Robitaille
Title
President/Ceo
Phone
(772) 223-4903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 904 FL Primary

Addresses

Primary practice location

509 SE Riverside Dr
Stuart, FL 34994-2579

Mailing address

PO Box 9033
Stuart, FL 34995-9033
Phone (772) 223-4903

Other names 1

  • MARTIN MEMORIAL SURGERY CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Martin Memorial Medicen5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1316966336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9033",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349959033",
            "telephone_number": "772-223-4903",
            "fax_number": "772-223-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SE RIVERSIDE DR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942579",
            "telephone_number": "772-223-4903",
            "fax_number": "772-223-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "ROBITAILLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "772-223-4903",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARTIN MEMORIAL SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.