Organization Active NPI

Ecb Dmall LLC

Doing business as Eye Center Boutique

  • Eyewear Supplier
  • Miami, FL
National Provider Identifier
1942919386
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
ECB DMALL LLC
Doing business as
Eye Center Boutique
Practice address
8888 SW 136TH St Ste 140
Miami, FL 33176-5870
Phone
(787) 672-4833
NPI assigned
Nov 15, 2022
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Mr. George Zambrana
Title
President
Phone
(787) 672-4833

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

8888 SW 136TH St Ste 140
Miami, FL 33176-5870

Mailing address

385 Calle San Claudio
San Juan, PR 00926-4251
Phone (787) 672-4833

Other names 1

  • EYE CENTER BOUTIQUE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GEORGE@CPAMEDPR.COM Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230525002099 FL Part B Supplier - Clinic/Group Practice 9234595786 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

8888 SW 136th St
Ste 140
Miami, FL 33176
Phone (786) 250-3024

385 Calle San Claudio
San Juan, PR 00926

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1942919386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE SAN CLAUDIO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264251",
            "telephone_number": "787-672-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8888 SW 136TH ST STE 140",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331765870",
            "telephone_number": "787-672-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECB DMALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "ZAMBRANA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-672-4833",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GEORGE@CPAMEDPR.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "8888 SW 136th St Ste 140",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331765870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.