# BREVARD UNIVERSAL CLINICAL SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902644644
- **Authorized official:** ANDREW GEORGE GROSSMAN (MD/OWNER)
- **Authorized official phone:** (973) 886-0045

## Contact information

- **Practice address:** 1385 CYPRESS AVE UNIT 107, MELBOURNE, FL 32935-5919
- **Practice address phone:** (973) 886-0045
- **Mailing address:** 1385 CYPRESS AVE UNIT 107, MELBOURNE, FL 32935-5919
- **Mailing address phone:** (973) 886-0045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2024
- **Last updated:** 12/04/2024