Individual provider · Type 1 NPI

Jacqueline Eleonore Rotta, MD

Student in an Organized Health Care Education/Training Program · Royal Oak, MI

NPI number 1235056409 Active

Practice location

3601 W. 13 Mile Road
Royal Oak, MI 48073

Call (248) 551-3000 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X4351056659 (MI)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1235056409

Jacqueline Eleonore Rotta, MD's National Provider Identifier is 1235056409, issued on Jun 30, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Royal Oak, MI. The record was last updated on Aug 19, 2026.