MEDICARE: HEALTHY PARTNERS MSO, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1811356538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY PARTNERS MSO, LLC

Provider Business Mailing Address
First Line	:	1090 JUPITER PARK DR
Second Line	:	SUITE 101
City	:	JUPITER
State	:	FL
Zip	:	33458-8939
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 JUPITER PARK DR
Second Line	:	SUITE 101
City	:	JUPITER
State	:	FL
Zip	:	33458-8939
Country	:	US
Telephone Number	:	561-745-3877
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ROBERT CAMERLINCK
Credential	:
Telephone Number	:	561-745-3877

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	02/23/2016

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