Provider Demographics
NPI:1366238255
Name:TOVAR, SONIA MILENA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MILENA
Last Name:TOVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7805 BAYMEADOWS CIR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1822
Mailing Address - Country:US
Mailing Address - Phone:904-302-0532
Mailing Address - Fax:
Practice Address - Street 1:7805 BAYMEADOWS CIR W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1822
Practice Address - Country:US
Practice Address - Phone:904-302-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily