Individual provider · Type 1 NPI

Lydia Ivette Vidal-Cardozo, PAC

Medical Physician Assistant · Myrtle Beach, SC

NPI number 1174533863 Active

Practice location

108 Finnegan Ct
Myrtle Beach, SC 29579-4205

Fax (843) 903-3366

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XC0000746 (MD)
Medical Physician Assistant Primary 363AM0700XPA1294 (SC)

Medical Physician Assistant: Definition to come...

5 other providers at this address

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About NPI 1174533863

Lydia Ivette Vidal-Cardozo, PAC's National Provider Identifier is 1174533863, issued on Aug 8, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Myrtle Beach, SC. The record was last updated on Jan 15, 2014.