Harbour Island Pediatrics

NPI #1790086429 in St Augustine, Florida

Provider Information

NPI Number: 1790086429
Entity Type: Organization
Organization Name: Harbour Island Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Nov 11, 2010
Last Updated: Nov 11, 2010

Practice Location

Address: 1301 PLANTATION ISLAND DR S
Address 2: SUITE 106-B
City: St Augustine
State: Florida
ZIP Code: 32080-3108
Phone: (904) 461-8906

Authorized Official

Name: DR. HOMERO VARELA SICANGCO JR., M.D.
Title: PRESIDENT
Phone: (904) 282-6331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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