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BREVARD UNIVERSAL CLINICAL SERVICES, LLC - Florida Company Profile

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Company Details

Entity Name: BREVARD UNIVERSAL CLINICAL SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 09 Oct 2023 (2 years ago)
Document Number: L23000465136
FEI/EIN Number 93-3899578
Address: 1385 CYPRESS AVENUE, MELBOURNE, FL, 32935, US
Mail Address: 500 Palm Springs Blvd,, Indian Harbor Beach, FL, 32937, US
ZIP code: 32935
City: Melbourne
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
GROSSMAN ANDREW Manager 500 Palm Springs Blvd,, Indian Harbor Beach, FL, 32937
INC AUTHORITY RA Agent 390 NORTH ORANGE AVE., STE 2300-N, ORLANDO, FL, 32801

National Provider Identifier

NPI Number:
1902644644
Certification Date:
2024-12-04

Authorized Person:

Name:
ANDREW GEORGE GROSSMAN
Role:
MD/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-05-20 1385 CYPRESS AVENUE, suite 107, MELBOURNE, FL 32935 -
CHANGE OF MAILING ADDRESS 2024-05-20 1385 CYPRESS AVENUE, suite 107, MELBOURNE, FL 32935 -

Documents

Name Date
ANNUAL REPORT 2024-05-20
Florida Limited Liability 2023-10-09

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Date of last update: 02 Jul 2025

Sources: Florida Department of State