Healthcare Provider Details

I. General information

NPI: 1902488174
Provider Name (Legal Business Name): JEAN LOUIS TOVAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 SW 42ND AVE FL 2
CORAL GABLES FL
33134-1962
US

IV. Provider business mailing address

8560 SW 89TH AVE
MIAMI FL
33173-4555
US

V. Phone/Fax

Practice location:
  • Phone: 305-203-5114
  • Fax:
Mailing address:
  • Phone: 305-497-9345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN28400
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN28400
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: