MEDICARE: DR. JESSICA DAWN AGUIRRE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	13270	SC

General Provider Information

NPI Number	:	1982556270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA DAWN AGUIRRE DPT

Provider Business Mailing Address
First Line	:	4125 DICK POND RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6807
Country	:	US
Telephone Number	:	843-999-0284
Fax Number	:	843-353-2707

Provider Business Practice Location Address
First Line	:	4125 DICK POND RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6807
Country	:	US
Telephone Number	:	843-999-0284
Fax Number	:	843-353-2707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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