Organization
HARBOUR ISLAND PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMERO VARELA SICANGCO JR. M.D. (PRESIDENT)
(904) 282-6331
Entity
Organization
Contact information
Practice address
1301 PLANTATION ISLAND DR S, SUITE 106-B, ST AUGUSTINE, FL 32080-3108
(904) 461-8906
(904) 461-8907
Mailing address
2250 CAVALRY BLVD, JACKSONVILLE, FL 32246-4201
(904) 282-6331
(904) 282-1550
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME71363
FL
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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