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LYDIA IVETTE VIDAL-CARDOZO PAC
NPI 1174533863
Physician Assistant - Medical in Myrtle Beach, SC

Active since August 08, 2006
108 FINNEGAN CT, MYRTLE BEACH, SC 29579(843) 909-9993(843) 903-3366 Get Directions Write a Review

NPPES record last updated: January 15, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lydia Ivette Vidal-cardozo Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYDIA IVETTE VIDAL-CARDOZO PAC (NPI 1174533863) is an individual medical provider in Myrtle Beach, South Carolina, licensed in South Carolina (PA1294) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1174533863
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLYDIA IVETTE VIDAL-CARDOZOCredential: PAC
Location Address108 FINNEGAN CTMyrtle Beach, SC 29579-4205
Mailing Address108 Finnegan CtMyrtle Beach, SC 29579-4205 · (843) 909-9993 · Fax (843) 903-3366
Phone(843) 909-9993
Fax(843) 903-3366
Sole ProprietorNo
Enumeration DateAugust 8, 2006
Last NPPES UpdateJanuary 15, 2014
✔ NPI 1174533863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in SC · PA1294
Also ListedFamily MedicineTaxonomy 207Q00000X · License C0000746 (MD)
108 FINNEGAN CT, Myrtle Beach, SC 29579
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Other Identifiers 4

Medicare ID-Type Unspecified199L
Medicare UPINAA50828627SC
Medicare PIN8627SC
Medicare UPINS71737

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY SAMUEL LINDABERRY D.O.
Family Medicine
108 FINNEGAN CT
MYRTLE BEACH, SC 29579
Horry County (843) 903-9993
DR. LINDABERRY AT CAROLINA FOREST, PC
Family Medicine
108 FINNEGAN CT
MYRTLE BEACH, SC 29579
Horry County (843) 903-9993
MCLEOD PHYSICIAN ASSOCIATES II
Family Medicine
108 FINNEGAN CT
MYRTLE BEACH, SC 29579
Horry County (843) 903-9993
ANNA ELIZABETH LARK PA-C
Physician Assistant
108 FINNEGAN CT
MYRTLE BEACH, SC 29579
Horry County (843) 903-9993
DR. JUSTIN CROSBY DO
Family Medicine
108 FINNEGAN CT
MYRTLE BEACH, SC 29579
Horry County (843) 903-9993

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lydia Vidal-cardozo's NPI number?

The NPI number for Lydia Vidal-cardozo is 1174533863. It was assigned to this individual provider in the NPPES registry on August 8, 2006.

Where is Lydia Vidal-cardozo located?

Lydia Vidal-cardozo practices at 108 Finnegan Ct, Myrtle Beach, SC 29579. The listed phone number is (843) 909-9993.

What is Lydia Vidal-cardozo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Lydia Vidal-cardozo was last updated on January 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.