DEAISA ZHANE BOMORT NPI 1558035717

NPI Information

  • NPI: 1558035717
  • Provider Name: DEAISA ZHANE BOMORT
  • Classification: Driver - 172A00000X
  • Entity Type: Individual
  • Address: 1836 N CRYSTAL LAKE DR
    LAKELAND, FL
    ZIP 33801
  • Phone: (863) 738-9493

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NPI Details

Deaisa Zhane Bomort is a driver in Lakeland, FL. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. Deaisa Zhane Bomort NPI is 1558035717. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1836 N CRYSTAL LAKE DR
LAKELAND, FL
ZIP 33801-576
Phone: (863) 738-9493

The enumeration date for this NPI number is 8/2/2021 and was last updated on 8/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1172A00000XDriverB563179949530FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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