Organization
EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC.
Active
Parent organization
EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC.
Authorized official
MARIANNE BASKIN (DIRECTOR)
(386) 226-7912
Entity
Organization
Contact information
Practice address
600 S CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-3966
(386) 226-7912
Mailing address
600 S CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-3966
(386) 226-7912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/03/2017
Last updated
07/21/2022
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