NPIMap

Organization Active NPI

Ecb Humacao

  • Optometrist
  • Fajardo, PR
National Provider Identifier
1104604768
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ECB HUMACAO
Practice address
Plaza Fajardo
Carr 3 KM 43.3 Suite 125
Fajardo, PR 00738
Phone
(787) 558-5501
NPI assigned
Sep 15, 2023
Organization subpart
Yes
Parent organization
ECB HUMACAOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gabriel Santos
Title
President
Phone
(787) 558-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

Plaza Fajardo
Carr 3 KM 43.3 Suite 125
Fajardo, PR 00738

Mailing address

Plaza Fajardo
Carr 3 KM 43.3 Suite 125
Fajardo, PR 00738
Phone (787) 801-5896

Other practice location 1

Palma Real
Carr 3 Suite 170
Humacao, PR 00791
Phone (787) 558-5502

Other practice location 2

Ave Rafael Cordero Esquina PR Local #10
Caguas, PR 00725
Phone (787) 558-5504

Other practice location 3

Rio Grande Town Center
Carr 3 Suite A-19
Rio Grande, PR 00745
Phone (787) 558-5503

Other names 1

  • Eye Center Boutique Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210127000537 PR Part B Supplier - Clinic/Group Practice 9931513371 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Fajardo, PR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ecb Humacao5 organizations share this tax ID, including this one
Part of
Ecb Humacao

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1104604768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PLAZA FAJARDO",
            "address_2": "CARR 3 KM 43.3 SUITE 125",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-801-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA FAJARDO",
            "address_2": "CARR 3 KM 43.3 SUITE 125",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-558-5501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Palma Real",
            "address_2": "Carr 3 Suite 170",
            "address_purpose": "LOCATION",
            "city": "Humacao",
            "state": "PR",
            "postal_code": "00791",
            "country_code": "US",
            "telephone_number": "787-558-5502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Ave Rafael Cordero Esquina PR Local #10",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "00725",
            "country_code": "US",
            "telephone_number": "787-558-5504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Rio Grande Town Center",
            "address_2": "Carr 3 Suite A-19",
            "address_purpose": "LOCATION",
            "city": "Rio Grande",
            "state": "PR",
            "postal_code": "00745",
            "country_code": "US",
            "telephone_number": "787-558-5503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ECB HUMACAO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ECB HUMACAO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-558-5501",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Center Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Center Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.