MEDICARE: DR. RONDA SUE FLECK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	90-38	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	920007138	OTHER	NM	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5219123	OTHER	NM	AETNA/PRONET
4	000000657912	OTHER	KY	BCBS COOP HEALTH
5	22213NM00	OTHER	NM	BLUESHIELD/NM
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	20705	OTHER	NM	LOVELACE HEALTHPLAN
8	713744	OTHER	NM	AHCCCS

General Provider Information

NPI Number	:	1285639443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONDA SUE FLECK M.D.

Provider Business Mailing Address
First Line	:	2207 CALLE CACIQUE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4944
Country	:	US
Telephone Number	:	505-985-6443
Fax Number	:	505-985-3212

Provider Business Practice Location Address
First Line	:	2428 W PIERCE ST
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3512
Country	:	US
Telephone Number	:	575-887-0272
Fax Number	:	575-628-0279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	09/08/2020

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