Individual
MR. MATTHEW ROBERT BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-C
Contact information
Practice address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(800) 539-4228
Mailing address
150 MAGNOLIA AVE, DAYTONA BEACH, FL 32114-4304
(800) 859-4228
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9287274
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11044631
FL
Other
Enumeration date
12/16/2024
Last updated
03/10/2026
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