Provider Demographics
NPI:1003009101
Name:PILOTO-BAKER, ISA (LCSW)
Entity Type:Individual
Prefix:
First Name:ISA
Middle Name:
Last Name:PILOTO-BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W 66TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6646
Mailing Address - Country:US
Mailing Address - Phone:305-558-2480
Mailing Address - Fax:305-826-3146
Practice Address - Street 1:430 W 66TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6646
Practice Address - Country:US
Practice Address - Phone:305-558-2480
Practice Address - Fax:305-826-3146
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW53941041C0700X
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health