Organization
BREVARD UNIVERSAL CLINICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW GEORGE GROSSMAN (MD/OWNER)
(973) 886-0045
Entity
Organization
Contact information
Practice address
1385 CYPRESS AVE UNIT 107, MELBOURNE, FL 32935-5919
(973) 886-0045
Mailing address
1385 CYPRESS AVE UNIT 107, MELBOURNE, FL 32935-5919
(973) 886-0045
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/17/2024
Last updated
12/04/2024
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