MEDICARE: CAROLINA TOVAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist		AZ

General Provider Information

NPI Number	:	1992549091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA TOVAR

Provider Business Mailing Address
First Line	:	5656 E GRANT RD STE 110
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2200
Country	:	US
Telephone Number	:	520-975-3136
Fax Number	:

Provider Business Practice Location Address
First Line	:	5656 E GRANT RD STE 110
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2200
Country	:	US
Telephone Number	:	520-975-3136
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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Directions to “ CAROLINA TOVAR ” Practice Location

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