Deaisa Zhane Bomort
Deaisa Zhane Bomort is a Driver in Lakeland, Florida. Practices as a sole proprietor. Licensed in Florida.
- Licensed in
- FL
- In the registry since
- 2021
Practice location Address checks out
1836 N Crystal Lake DrLakeland, FL 33801-6576
Phone: (863) 738-9493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence B563179949530 (FL) |
|---|
Record details
| NPI number | 1558035717 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | August 2, 2021 |
| Last updated in NPPES | August 2, 2021 |
| Certification date | August 2, 2021 |
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