HARBOUR ISLAND PEDIATRICS
NPI 1790086429
Pediatrics in St Augustine, FL
NPI Status: Active since November 11, 2010
Contact Information
1301 PLANTATION ISLAND DR S
SUITE 106-B
ST AUGUSTINE, FL
ZIP 32080
Phone: (904) 461-8906
Fax: (904) 461-8907
- Organization
- Pediatrics
- Accepts Insurance
- CLIA Number: 10D2017974
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 12-21-2026
About HARBOUR ISLAND PEDIATRICS
This page provides the complete NPI Profile along with additional information for Harbour Island Pediatrics, a pediatrician established in St Augustine, Florida operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1790086429 assigned on November 2010. The practitioner's primary taxonomy code is 208000000X with license number ME71363 (FL). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Homero Varela Sicangco Jr. M.d. (President)
- NPI
- 1790086429
- Provider Name
- HARBOUR ISLAND PEDIATRICS
- Entity Type
- Organization
- Location Address
- 1301 PLANTATION ISLAND DR S SUITE 106-B ST AUGUSTINE, FL 32080
- Location Phone
- (904) 461-8906
- Location Fax
- (904) 461-8907
- Mailing Address
- 2250 CAVALRY BLVD JACKSONVILLE, FL 32246
- Mailing Phone
- (904) 282-6331
- Mailing Fax
- (904) 461-8907
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-11-2010
- Last Update Date
- 11-11-2010
- Code Navigator
A pediatrician like Harbour Island Pediatrics is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME71363
- License State
- FL
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- AvMed Entrust Bronze 600 (2025) - HMO
- AvMed Entrust Bronze 650 (2025) - HMO
- AvMed Entrust Expanded Bronze Standard (2025) - HMO
- AvMed Entrust Gold 125 (2025) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
- AvMed Entrust Gold Standard (2025) - HMO
- AvMed Entrust Platinum 25 (2025) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
- AvMed Entrust Platinum Standard (2025) - HMO
- AvMed Entrust Silver 350 (2025) - HMO
- AvMed Entrust Silver 350 Dental+Vision (2025) - HMO
- AvMed Entrust Silver 550 (2025) - HMO
- AvMed Entrust Silver 550 Dental+Vision (2025) - HMO
- AvMed Entrust Silver Standard (2025) - HMO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
- BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2017974
- Facility Type
- Practitioner Other
- Certificate Effective Date
- December 22, 2024
- Certificate Expiration Date
- December 21, 2026
- Laboratory Director
- HOMERO V. SICANGCO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Harbour Island Pediatrics to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 9 | 0 | 0 | 8 | 6 | 4 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 0 | 8 | 12 | 4 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 0 + 8 + 1 + 2 + 4 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1790086429 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1730292517 | DR. DOUGLAS L JOHNSON DMD Individual | Oral & Maxillofacial Surgery | 1301 PLANTATION ISLAND DR S SUITE 101 ST AUGUSTINE, FL 32080 (904) 460-0505 |
| 1316012743 | DR. CARMEN C VIVERO M.D. Individual | Internal Medicine (Addiction Medicine) | 1301 PLANTATION ISLAND DR S SUITE 402-B ST AUGUSTINE, FL 32080 (904) 460-0707 |
| 1093939688 | DR. FRANCISCO DIAZ JR. D.M.D. Individual | Dentist (General Practice) | 1301 PLANTATION ISLAND DR S SUITE 104 B ST AUGUSTINE, FL 32080 (904) 461-5566 |
| 1629288824 | ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA Organization | Oral & Maxillofacial Surgery | 1301 PLANTATION ISLAND DR S SUITE 101 ST AUGUSTINE, FL 32080 (904) 460-0505 |
| 1457523003 | INSTITUTE OF INTERNAL MEDICINE P A Organization | Internal Medicine | 1301 PLANTATION ISLAND DR S STE 402B ST AUGUSTINE, FL 32080 (904) 460-0707 |
| 1720236383 | ANCIENT CITY MIDWIVES INC Organization | Advanced Practice Midwife | 1301 PLANTATION ISLAND DR S STE 105-B ST AUGUSTINE, FL 32080 (904) 826-1007 |
| 1093954208 | MEDICAL PROFESSIONALS OF NORTH FLORIDA Organization | Internal Medicine | 1301 PLANTATION ISLAND DR S SUITE 106A SAINT AUGUSTINE, FL 32080 (904) 460-9191 |
| 1184648495 | DR. BARRY F DOBIES M.D. Individual | Internal Medicine (Cardiovascular Disease) | 1301 PLANTATION ISLAND DR S SUITE 104A ST AUGUSTINE, FL 32080 (904) 471-4441 |
| 1518135896 | BARRY F DOBIES MD PA Organization | Internal Medicine | 1301 PLANTATION ISLAND DR S SUITE 104A ST AUGUSTINE, FL 32080 (904) 471-4441 |
| 1447303375 | MRS. KIMBERLEE YSELONIA LCSW Individual | Social Worker (Clinical) | 1301 PLANTATION ISLAND DR S SUITE 201A ST AUGUSTINE, FL 32080 (904) 808-7362 |
| 1033528872 | MICHAEL HINES Individual | Hearing Instrument Specialist | 1301 PLANTATION ISLAND DR S SUITE 401B ST AUGUSTINE, FL 32080 (904) 264-0075 |
| 1588833958 | LEIANE MOORE BOUDREAU ARNP Individual | Nurse Practitioner | 1301 PLANTATION ISLAND DR S SUITE 106A SAINT AUGUSTINE, FL 32080 (904) 460-9191 |
| 1447362058 | DR. RONALD D FUDALA DC,DACAN Individual | Chiropractor (Neurology) | 1301 PLANTATION ISLAND DR S SUITE 402 A SAINT AUGUSTINE, FL 32080 (904) 471-4744 |
| 1770504755 | INTEGRATIVE PAIN SOLUTIONS, PL Organization | Physical Medicine & Rehabilitation (Pain Medicine) | 1301 PLANTATION ISLAND DR S SUITE 402A ST AUGUSTINE, FL 32080 (904) 471-4744 |
| 1457411373 | REZ INC Organization | Clinic/Center (Primary Care) | 1301 PLANTATION ISLAND DR S SUITE 402 B ST AUGUSTINE, FL 32080 (904) 823-3777 |
| 1629286299 | ST. AUGUSTINE PEDIATRIC ASSOCIATES, PA Organization | Pediatrics | 1301 PLANTATION ISLAND DR S SUITE 106B ST AUGUSTINE, FL 32080 (904) 461-8906 |
| 1770942260 | NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES, PA Organization | Specialist | 1301 PLANTATION ISLAND DR S SUITE 203A ST AUGUSTINE, FL 32080 (904) 384-2240 |
| 1730549817 | PHYSICIAN ASSOCIATES GROUP, INC. Organization | Psychiatry & Neurology (Addiction Medicine) | 1301 PLANTATION ISLAND DR S SUITE 201-A ST AUGUSTINE, FL 32080 (904) 342-5965 |
| 1962719492 | ALEJANDRO NAVARRO PA-C Individual | Physician Assistant (Medical) | 1301 PLANTATION ISLAND DR S STE 140 ST AUGUSTINE, FL 32080 (904) 461-6060 |
| 1407390529 | DR. NAKISHA MARIE CARRASQUILLO-RICHARDSON L. P. Individual | Psychologist | 1301 PLANTATION ISLAND DR S STE. 201 A ST AUGUSTINE, FL 32080 (904) 342-5965 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790086429, enumerated in the NPI registry as an "organization" on November 11, 2010
The provider is located at 1301 Plantation Island Dr S Suite 106-b St Augustine, Fl 32080 and the phone number is (904) 461-8906
This medical organization specializes in Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Ambetter Health, Ambetter of Alabama, AvMed,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D2017974 for a "practitioner other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 11, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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