DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DEAISA ZHANE BOMORT

Active Sole Proprietor

DEAISA ZHANE BOMORT is a Driver healthcare provider located in LAKELAND, Florida. NPI 1558035717 is currently active in the NPPES registry. Verify at CMS.

Driver · LAKELAND, FL

Registration Details

NPI Number
1558035717
Provider Type
Individual
Gender
Female
NPI Issued
Aug 2, 2021 (5.0054796517567 yrs)
Last Updated
Aug 2, 2021
License
B563179949530 (FL)
Sole Proprietor
Yes

Practice Information

Address
1836 N CRYSTAL LAKE DR
LAKELAND, FL, 338016576
Browse FL providers · Browse ZIP 33801
Phone
8637389493
Primary Specialty
Driver
172A00000X

Other Driver Providers in LAKELAND, FL

Name Credential NPI
GREGORY CLARK 1760991012
MONICA SMITH 1720632896
AMANDA RICHARDS 1023614195
MICHELLE DENISE SCOTT 1598455594
FELICIA JORDAN 1184493629
MR. RODNEY W STREET SR. 1669238341
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.