Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Embry-Riddle Aeronautical University, Inc

Organization Family Medicine Physician · NPI 1679097307

Embry-Riddle Aeronautical University, Inc is a Family Medicine Physician in Daytona Beach, Florida. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

600 S Clyde Morris Blvd
Daytona Beach, FL 32114-3966
Phone: (386) 226-7912
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Family Medicine Physician Taxonomy 207Q00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1679097307
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEmbry-Riddle Aeronautical University, Inc
Authorized official Marianne Baskin — Director · (386) 226-7912
NPI enumeratedAugust 3, 2017
Last updated in NPPESJuly 21, 2022
Mailing address600 S Clyde Morris Blvd, Daytona Beach, FL 32114-3966

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