Provider Demographics
NPI:1033924758
Name:BROWARD PACE PROGRAM LLC
Entity type:Organization
Organization Name:BROWARD PACE PROGRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIMARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-762-1379
Mailing Address - Street 1:1700 NW 49TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3763
Mailing Address - Country:US
Mailing Address - Phone:954-768-6232
Mailing Address - Fax:
Practice Address - Street 1:1700 NW 49TH ST STE 150
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3763
Practice Address - Country:US
Practice Address - Phone:954-768-6232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization