Harbour Island Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME71363 Issued in FL

Legal business name

HARBOUR ISLAND PEDIATRICS

Practice address

1301 Plantation Island Dr S
Suite 106-B
St Augustine, FL 32080-3108

Phone

(904) 461-8906

Fax

(904) 461-8907

NPI assigned

Nov 11, 2010

Last updated

Nov 11, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Homero Varela Sicangco Jr., M.D.NPI 1780753251

Title

President

Phone

(904) 282-6331

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73764

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Homero Sicangco, M.D.

  • Pediatrics Physician
  • St Augustine, FL
  • NPI 1780753251
  NPD Authorized official
• Maria Victoria Kilayko Sicangco, MD

  • Pediatrics Physician
  • St Augustine, FL
  • NPI 1508079484
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1790086429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CAVALRY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464201",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 106-B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-461-8906",
            "fax_number": "904-461-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOUR ISLAND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "SICANGCO",
        "authorized_official_first_name": "HOMERO",
        "authorized_official_middle_name": "VARELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-282-6331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME71363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Hankins
• Jacqueline Hansen
• Happy Helpers Autism Center LLC
• Happy Smiles Orthodontics
• Harbour Dental Care, P.a.
• Annie Grace Hardwick, LMHC
• Tracey Young Hardy, LMHC
• Daniela Maria Harirchi, APRN
• Harmony Senior Service Inc (Harmony Senior Services Inc)
• Harmony Senior Services Inc.

• Pediatrics Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.