Healthcare Provider Details

I. General information

NPI: 1215848825
Provider Name (Legal Business Name): ANGELA N LUMIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 BIRDIE WAY
APOLLO BEACH FL
33572-2704
US

IV. Provider business mailing address

5031 BORDEAUX VILLAGE PL UNIT 201
TAMPA FL
33617-3044
US

V. Phone/Fax

Practice location:
  • Phone: 813-350-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: