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HARBOUR ISLAND PEDIATRICS
NPI 1790086429
Pediatrics in St Augustine, FL

Active since November 11, 2010CLIA 10D2017974 · Waiver
1301 PLANTATION ISLAND DR S, SUITE 106-B, ST AUGUSTINE, FL 32080(904) 461-8906(904) 461-8907 Get Directions Write a Review

NPPES record last updated: November 11, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Harbour Island Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HARBOUR ISLAND PEDIATRICS (NPI 1790086429) is a healthcare organization registered as a pediatrics in St Augustine, Florida and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Homero Varela Sicangco, President, as its authorized official.

NPPES Registry Identity

NPI1790086429
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameHARBOUR ISLAND PEDIATRICS
Location Address1301 PLANTATION ISLAND DR S, SUITE 106-BSt Augustine, FL 32080-3108
Mailing Address2250 Cavalry BlvdJacksonville, FL 32246-4201 · (904) 282-6331 · Fax (904) 282-1550
Phone(904) 461-8906
Fax(904) 461-8907
Organization SubpartNo
Authorized OfficialHomero Varela SicangcoPresident · (904) 282-6331
Enumeration DateNovember 11, 2010
✔ NPI 1790086429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME71363
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1301 PLANTATION ISLAND DR S, St Augustine, FL 32080
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2017974

Harbour Island Pediatrics LLC · Saint Augustine, FL
Active · expires Dec 21, 2026
CLIA Number10D2017974
Laboratory TypePractitioner Other
Certificate Effective DateDecember 22, 2024
Certificate Expiration DateDecember 21, 2026
Laboratory DirectorHomero V. Sicangco
Laboratory Phone(904) 461-8906
Laboratory LocationHarbour Island Pediatrics LLC1301 Plantation Island Dr Ste 105 B, Saint Augustine, FL 32080
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MELCHOR G BARROS MD
Family Medicine
1301 PLANTATION ISLAND DR S, 102-B
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-2593
RYAN J PEREIRA DPM
Podiatrist (Foot & Ankle Surgery)
1301 PLANTATION ISLAND DR S, STE 203
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-0821
DR. MIGUEL A MAS JR. MD
Pediatrics
1301 PLANTATION ISLAND DR S, SUITE 404
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-1560
MICHAEL HINES
Hearing Instrument Specialist
1301 PLANTATION ISLAND DR S, SUITE 401B
ST AUGUSTINE, FL 32080
St. Johns County (904) 264-0075
DR. FRANCISCO DIAZ JR. D.M.D.
Dentist (General Practice)
1301 PLANTATION ISLAND DR S, SUITE 104 B
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-5566
MEDICAL PROFESSIONALS OF NORTH FLORIDA
Internal Medicine
1301 PLANTATION ISLAND DR S, SUITE 106A
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 460-9191
SCOTT FORREST CORNEAL DO
Physical Medicine & Rehabilitation (Pain Medicine)
1301 PLANTATION ISLAND DR S, SUITE 402A
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-4744
DR. CARMEN C VIVERO M.D.
Internal Medicine (Addiction Medicine)
1301 PLANTATION ISLAND DR S, SUITE 402-B
ST AUGUSTINE, FL 32080
St. Johns County (904) 460-0707

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Harbour Island Pediatrics's NPI number?

The NPI number for Harbour Island Pediatrics is 1790086429. It was assigned to this organization in the NPPES registry on November 11, 2010.

Where is Harbour Island Pediatrics located?

Harbour Island Pediatrics is located at 1301 Plantation Island Dr S Suite 106-B, St Augustine, FL 32080. The listed phone number is (904) 461-8906.

What is Harbour Island Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Harbour Island Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2017974) is associated with this NPI, valid through December 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Harbour Island Pediatrics accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Harbour Island Pediatrics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Harbour Island Pediatrics was last updated on November 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.