Individual
MR. HOMERO SICANGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PLANTATION ISLAND DR S, #105-B, ST AUGUSTINE, FL 32080-3108
(904) 461-8906
(904) 461-8907
Mailing address
2950 MONTILLA DR, JACKSONVILLE, FL 32246-5526
(904) 461-8906
(904) 461-8907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME71363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002981500
—
FL
01
—
2762240
CIGNA
FL
01
—
51003
BCBS
FL
Enumeration date
11/07/2006
Last updated
07/05/2017
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