Healthcare Provider Details

I. General information

NPI: 1457395170
Provider Name (Legal Business Name): MICHAEL ANGELO LEONIO AQUINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SANTA BARBARA BLVD STE 102
CAPE CORAL FL
33991-2038
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-1900
  • Fax: 239-424-1908
Mailing address:
  • Phone: 239-424-1900
  • Fax: 239-424-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME178768
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD066968L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME178768
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD066968L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: