Provider Demographics
NPI:1992402598
Name:ECB CAYEY CORP
Entity type:Organization
Organization Name:ECB CAYEY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FABIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-360-3006
Mailing Address - Street 1:2Q6 CALLE 17
Mailing Address - Street 2:MIRADOR DE BAIROA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1006
Mailing Address - Country:US
Mailing Address - Phone:787-924-4700
Mailing Address - Fax:787-731-5642
Practice Address - Street 1:8000 AVE JESUS T PINERO
Practice Address - Street 2:SUITE 15 PLAZA CAYEY
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-5578
Practice Address - Country:US
Practice Address - Phone:178-792-4470
Practice Address - Fax:787-731-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier