Lydia Ivette Vidal-cardozo, PAC is a
Physician Assistant - Medical physician based in Myrtle Beach, South Carolina. Lydia Ivette Vidal-cardozo is licensed to practice in South Carolina (license number PA1294) and her current practice location is 108 Finnegan Ct, Myrtle Beach, South Carolina. She can be reached at her office (for appointments etc.) via phone at
(843) 909-9993.
NPI number for Lydia Ivette Vidal-cardozo is 1174533863 and her current mailing address is 108 Finnegan Ct, Myrtle Beach, South Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174533863.
Physician's Profile
| Full Name | Lydia Ivette Vidal-cardozo |
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| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 108 Finnegan Ct, Myrtle Beach, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1174533863
- Provider Enumeration Date: 08/08/2006
- Last Update Date: 01/15/2014
Medical Identifiers
Medical identifiers for Lydia Ivette Vidal-cardozo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174533863 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | C0000746 (Maryland) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA1294 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lydia Ivette Vidal-cardozo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lydia Ivette Vidal-cardozo, PAC
108 Finnegan Ct,
Myrtle Beach, SC 29579-4205
Ph: (843) 909-9993 | Lydia Ivette Vidal-cardozo, PAC
108 Finnegan Ct,
Myrtle Beach, SC 29579-4205
Ph: (843) 909-9993 |
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