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Individual

JASON MICHAEL ROTONDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102
(505) 727-8206
Mailing address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-8206

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R66741
NM
363LA2100X
Acute Care Nurse Practitioner
Primary
53629
NM

Other

Enumeration date
07/30/2018
Last updated
09/04/2018
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