Provider Demographics
NPI:1194605253
Name:TOVAR TAJAN, SOFIA ISABELA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:ISABELA
Last Name:TOVAR TAJAN
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 1:8354 NW 51ST TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5647
Mailing Address - Country:US
Mailing Address - Phone:786-661-7323
Mailing Address - Fax:
Practice Address - Street 1:8354 NW 51ST TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5647
Practice Address - Country:US
Practice Address - Phone:786-661-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician