Healthcare Provider Details
I. General information
NPI: 1811804008
Provider Name (Legal Business Name): FLORICA OMUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
218 PORTIA CIR
HOT SPRINGS AR
71913-9620
US
IV. Provider business mailing address
218 PORTIA CIR # A
HOT SPRINGS AR
71913-9620
US
V. Phone/Fax
- Phone: 501-655-9572
- Fax:
- Phone: 501-655-9572
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: