Provider Demographics
NPI:1629692140
Name:ROTONDO, KELSEE LEIGH (DO)
Entity Type:Individual
Prefix:DR
First Name:KELSEE
Middle Name:LEIGH
Last Name:ROTONDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1803
Mailing Address - Country:US
Mailing Address - Phone:810-762-1575
Mailing Address - Fax:810-762-4494
Practice Address - Street 1:420 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1803
Practice Address - Country:US
Practice Address - Phone:810-762-1575
Practice Address - Fax:810-762-4494
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151014359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine