Provider Demographics
NPI:1245971746
Name:ALTAHONA SOVEN, MARIA ANGELICA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELICA
Last Name:ALTAHONA SOVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANGELICA
Other - Last Name:ALTAHONA SOVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:808 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2917
Mailing Address - Country:US
Mailing Address - Phone:954-544-8752
Mailing Address - Fax:
Practice Address - Street 1:808 HAMPTON CT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2917
Practice Address - Country:US
Practice Address - Phone:954-544-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN289651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDRPM2411OtherBOARD PERMIT