Provider Demographics
NPI:1285948810
Name:ROTONDO, RONNY L (MDCM)
Entity type:Individual
Prefix:DR
First Name:RONNY
Middle Name:L
Last Name:ROTONDO
Suffix:
Gender:M
Credentials:MDCM
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Mailing Address - Street 1:4001 RAINBOW BLVD # MS 4033
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8504
Mailing Address - Country:US
Mailing Address - Phone:913-588-3600
Mailing Address - Fax:913-588-3663
Practice Address - Street 1:4001 RAINBOW BLVD # MS 4033
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8504
Practice Address - Country:US
Practice Address - Phone:913-588-3600
Practice Address - Fax:913-588-3663
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04426172085R0001X
FLTRN166892085R0001X
FLMFC17072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology