Healthcare Provider Details

I. General information

NPI: 1023932977
Provider Name (Legal Business Name): SICA MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 189 KM 24.2 BO. COLLORES
LAS PIEDRAS PR
00771
US

IV. Provider business mailing address

340 CALLE CAOBA URB. LOS SAUCES
HUMACAO PR
00791-4911
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-6180
  • Fax:
Mailing address:
  • Phone: 787-486-6180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SIFUENTES CARRASQUILLO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-486-6180