Provider Demographics
NPI:1376856849
Name:PILOTO, SANDRA (MA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:PILOTO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6961 W 14TH CT APT 204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4568
Mailing Address - Country:US
Mailing Address - Phone:305-454-2243
Mailing Address - Fax:
Practice Address - Street 1:1750 W 39TH PL STE 1001
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7036
Practice Address - Country:US
Practice Address - Phone:305-454-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42219225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist