Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deaisa Zhane Bomort

Individual provider Driver · NPI 1558035717

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 Dr
Lakeland, FL 33801-6576
Phone: (863) 738-9493
Show map & directions

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 number1558035717
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 2, 2021
Last updated in NPPESAugust 2, 2021
Certification dateAugust 2, 2021
Mailing address1836 N Crystal Lake Dr, Lakeland, FL 33801-6576

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