Individual ProviderMaria Angelica AltahonaDentistDental ProvidersPractice Address6221 Robert Ln Apt 403c, Davie, FL 33314-4453(954) 544-8752PECOS EnrollmentBased on the most recent information from CMS, provider Maria Angelica Altahona does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1245971746Provider TypeIndividualFull NameAltahona, Maria AngelicaGenderFemaleSole ProprietorYesEnumeration Date4/6/2022Last Updated4/6/2022Contact InformationPractice LocationPractice Address6221 Robert Ln Apt 403c, Davie, FL 33314-4453Phone(954) 544-8752FaxUnlisted FaxMailing LocationMailing Address6221 Robert Ln Apt 403c, Davie, FL 33314-4453Phone(954) 544-8752FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseDRPM2411FloridaProvider IdentifiersIDDescriptionIssuerIDDRPM2411DescriptionOtherIssuerBOARD PERMITFlorida