OrganizationActive
Embry-Riddle Aeronautical University, Inc.
NPI 1679097307 · General Practice Physician · Daytona Beach, FL
Provider details
- NPI number
- 1679097307
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Embry-Riddle Aeronautical University, Inc.
- Organization subpart
- Yes
- Authorized official
- Marianne Baskin, Director(386) 226-7912
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
600 S Clyde Morris Blvd
Daytona Beach, FL 32114-3966
Phone: (386) 226-7912
Street-level locationGet directions
Mailing address
600 S Clyde Morris Blvd
Daytona Beach, FL 32114-3966
Registry dates
- Enumerated
- 2017-08-03
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.