Healthcare Provider Details

I. General information

NPI: 1619906773
Provider Name (Legal Business Name): ROMMEL AQUINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6175 LAPEER RD
BURTON MI
48509-2417
US

IV. Provider business mailing address

6175 LAPEER RD
BURTON MI
48509-2417
US

V. Phone/Fax

Practice location:
  • Phone: 810-743-1408
  • Fax: 810-743-1561
Mailing address:
  • Phone: 810-743-1408
  • Fax: 810-743-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301079850
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: