Healthcare Provider Details

I. General information

NPI: 1063343085
Provider Name (Legal Business Name): ECO MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 CALLE SANTA CRUZ STE 305
BAYAMON PR
00961-7036
US

IV. Provider business mailing address

68 CALLE SANTA CRUZ STE 305
BAYAMON PR
00961-7036
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTEFANIA CRUZVAL O'REILLY
Title or Position: PRESIDENT
Credential: MD
Phone: 787-300-9994