Individual
IVANA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4600 OLEANDER DR STE B, MYRTLE BEACH, SC 29577-5897
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3836
SC
363AM0700X
Medical Physician Assistant
3836
SC
Other
Enumeration date
10/08/2021
Last updated
07/03/2023
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