Provider Demographics
NPI:1003606013
Name:FLOYD, OMAR
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:FLOYD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9604 SURRATTS MANOR DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3076
Mailing Address - Country:US
Mailing Address - Phone:227-220-5436
Mailing Address - Fax:
Practice Address - Street 1:1355 MARYLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4407
Practice Address - Country:US
Practice Address - Phone:227-220-5436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider