Deaisa Zhane Bomort

Driver · Lakeland, FL

Individual Active NPI

NPI number 1558035717

Practice location

1836 N Crystal Lake Dr
Lakeland, FL 33801-6576
Phone
(863) 738-9493

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NPI record

NPI
1558035717
Entity type
Individual (Type 1)
Enumeration date
August 2, 2021
Last updated
August 2, 2021
Certified
August 2, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Driver Primary 172A00000X B563179949530 FL

About Deaisa Bomort

Deaisa Zhane Bomort is a healthcare provider registered in the NPI registry with the primary taxonomy Driver (code 172A00000X). The practice location is 1836 N Crystal Lake Dr, Lakeland, FL 33801-6576. The NPI number 1558035717 was assigned on August 2, 2021 and the record was last updated on August 2, 2021.

Deaisa Bomort lists a license in the registry: #B563179949530 (FL) for Driver. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Deaisa Zhane Bomort?

The NPI number is 1558035717.

What is the phone number of Deaisa Bomort?

The phone number listed for the practice location is (863) 738-9493.

Where is Deaisa Bomort located?

1836 N Crystal Lake Dr, Lakeland, FL 33801-6576.

What is the taxonomy code for Deaisa Bomort?

The primary taxonomy code is 172A00000X – Driver.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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