Organization Active NPI

E C Boutique Corp

  • Eyewear Supplier
  • Bayamon, PR
National Provider Identifier
1689973778
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
E C BOUTIQUE CORP
Doing business as
EYE CENTER BOUTIQUE
Practice address
501 Ave West Main Suite 1215
Plaza del Sol
Bayamon, PR 00961-3867
Phone
(787) 780-4444
Fax
(787) 780-4444
NPI assigned
Mar 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Pedro D Salib Frau
Title
President
Phone
(787) 780-4444

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 135 PR
Clinic/Center 261Q00000X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

501 Ave West Main Suite 1215
Plaza del Sol
Bayamon, PR 00961-3867

Mailing address

90 Parque Medici
Urb Paseo del Parque
San Juan, PR 00926-6514
Phone (787) 780-4444

Other names 1

  • EYE CENTER BOUTIQUE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
E C Boutique Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1689973778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PARQUE MEDICI",
            "address_2": "URB PASEO DEL PARQUE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266514",
            "telephone_number": "787-780-4444",
            "fax_number": "787-780-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AVE WEST MAIN SUITE 1215",
            "address_2": "PLAZA DEL SOL",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613867",
            "telephone_number": "787-780-4444",
            "fax_number": "787-780-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E C BOUTIQUE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "SALIB FRAU",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-780-4444"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PR",
            "license": "135",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE CENTER BOUTIQUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.