| Brevard Universal Clinical Services, Llc | |
|
1385 Cypress Ave Unit 107 Melbourne FL 32935-5919 | |
| (973) 886-0045 | |
| Not Available |
| Full Name | Brevard Universal Clinical Services, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1385 Cypress Ave Unit 107, Melbourne, Florida |
| Authorized Official Name and Position | Andrew George Grossman (MD/OWNER) |
| Authorized Official Contact | 9738860045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Universal Clinical Services, Llc 1385 Cypress Ave Unit 107 Melbourne FL 32935-5919 Ph: (973) 886-0045 | Brevard Universal Clinical Services, Llc 1385 Cypress Ave Unit 107 Melbourne FL 32935-5919 Ph: (973) 886-0045 |
| NPI Number | 1902644644 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 12/04/2024 |
| Medicare PECOS PAC ID | 1557899382 |
|---|---|
| Medicare Enrollment ID | O20250108000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902644644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Andrew G Grossman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528026853 PECOS PAC ID: 3678521580 Enrollment ID: I20140523000158 |
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