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

Derral Bomar

Individual provider Case Manager/Care Coordinator · NPI 1912483751

Derral Bomar is a Case Manager/Care Coordinator in Lake City, Florida. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

439 SW Michigan St
Lake City, FL 32025-0440
Phone: (352) 374-5600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1912483751
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 16, 2018
Last updated in NPPESJuly 16, 2018
Mailing address4300 Sw 13th St, Gainesville, FL 32608-4006

Other providers in Lake City