Provider Demographics
NPI:1952038564
Name:GEENSBURG, PATRICIA (DOM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GEENSBURG
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MILITARY TRL STE 22-224
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2869
Mailing Address - Country:US
Mailing Address - Phone:760-500-9974
Mailing Address - Fax:
Practice Address - Street 1:3333 CENTRAL GARDENS CIR APT 204
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8704
Practice Address - Country:US
Practice Address - Phone:760-500-9974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine