Provider Demographics
NPI:1821218231
Name:GERAGHTY, PATRICIA RAUSCH (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:RAUSCH
Last Name:GERAGHTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 WESTHALL LN FL 4
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7102
Mailing Address - Country:US
Mailing Address - Phone:407-200-2700
Mailing Address - Fax:407-200-4947
Practice Address - Street 1:1000 WATERMAN WAY
Practice Address - Street 2:MAMMOGRAPHY CENTER
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5266
Practice Address - Country:US
Practice Address - Phone:352-253-3235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000494522085R0202X, 2085R0202X
FLME1314952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1060586Medicaid
WA0234159OtherLABOR & INDUSTRIES
WA8510141Medicaid
WA8947055OtherCRIME VICTIMS
WA279998OtherL&I
WA1060586Medicaid
WAG8907497Medicare PIN
WAG8907499Medicare PIN
WA8900873Medicare PIN
WA8900872Medicare PIN
WAG8874216Medicare UPIN