Provider Demographics
NPI:1114550845
Name:INOA, PEDRO (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:INOA
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 NW 165TH STREET RD APT C604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6450
Mailing Address - Country:US
Mailing Address - Phone:305-807-6612
Mailing Address - Fax:
Practice Address - Street 1:494 NW 165TH STREET RD
Practice Address - Street 2:C 604
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6465
Practice Address - Country:US
Practice Address - Phone:305-807-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL170841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical