Healthcare Provider Details
I. General information
NPI: 1366314874
Provider Name (Legal Business Name): INTEGRATIVE PM & R
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
SANTA ROSA MALL SUITE 218
BAYAMON PR
00961
US
IV. Provider business mailing address
PLACID COURT #73 APT. 5C
SAN JUAN PR
00907
US
V. Phone/Fax
- Phone: 787-694-4038
- Fax: 787-269-5686
- Phone: 787-694-4038
- Fax: 787-269-5686
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EDUARDO
COSS ALAMO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-694-4038