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DEAISA ZHANE BOMORT
NPI 1558035717
Driver in Lakeland, FL

Active since August 02, 2021
1836 N CRYSTAL LAKE DR, LAKELAND, FL 33801(863) 738-9493 Get Directions Write a Review

NPPES record last updated: August 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Deaisa Zhane Bomort NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEAISA ZHANE BOMORT (NPI 1558035717) is an individual driver provider in Lakeland, Florida, licensed in Florida (B563179949530) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1558035717
Entity TypeIndividualFemale
Primary Taxonomy172A00000X
Provider Legal NameDEAISA ZHANE BOMORT
Location Address1836 N CRYSTAL LAKE DRLakeland, FL 33801-6576
Mailing Address1836 N Crystal Lake DrLakeland, FL 33801-6576 · (863) 738-9493
Phone(863) 738-9493
Sole ProprietorYes
Enumeration DateAugust 2, 2021
NPPES CertifiedAugust 2, 2021
✔ NPI 1558035717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDriverOther Service Providers
Taxonomy Code172A00000X
License✔ Licensed in FL · B563179949530
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
1836 N CRYSTAL LAKE DR, Lakeland, FL 33801
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CREATIVE SPEECH SOLUTIONS
Developmental Therapist
1836 N CRYSTAL LAKE DR, UNIT 72
LAKELAND, FL 33801
Polk County (708) 205-8186

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deaisa Bomort's NPI number?

The NPI number for Deaisa Bomort is 1558035717. It was assigned to this individual provider in the NPPES registry on August 2, 2021.

Where is Deaisa Bomort located?

Deaisa Bomort practices at 1836 N Crystal Lake Dr, Lakeland, FL 33801. The listed phone number is (863) 738-9493.

What is Deaisa Bomort's specialty?

The primary specialty registered for this NPI is Driver with taxonomy code 172A00000X.

When was this NPI record last updated?

The NPPES record for Deaisa Bomort was last updated on August 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.