Provider Demographics
NPI:1659628956
Name:BROWARD PRIMARY PARTNERS LLC
Entity Type:Organization
Organization Name:BROWARD PRIMARY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERLINCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-371-4142
Mailing Address - Street 1:250 S CENTRAL BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 S CENTRAL BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8812
Practice Address - Country:US
Practice Address - Phone:561-745-3877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization