Healthcare Provider Details

I. General information

NPI: 1780594325
Provider Name (Legal Business Name): LILY UMANSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 N DALE MABRY HWY
TAMPA FL
33614-2665
US

IV. Provider business mailing address

1011 59TH AVE N
ST PETERSBURG FL
33703-1125
US

V. Phone/Fax

Practice location:
  • Phone: 813-932-2222
  • Fax:
Mailing address:
  • Phone: 859-753-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT27493
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: