DEAISA BOMORT
Driver
Active
Individual
NPI: 1558035717
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Driver | 172A00000X | Yes | B563179949530 (FL) |
Frequently Asked Questions
NPI 1558035717 is the National Provider Identifier for DEAISA BOMORT, a Driver provider located in Lakeland, FL. This NPI was enumerated on August 2, 2021.
DEAISA BOMORT practices at 1836 N CRYSTAL LAKE DR, Lakeland, FL 33801.
Quick Facts
- NPI
- 1558035717
- Type
- Individual
- Enumerated
- Aug 2, 2021
- Last Updated
- Aug 2, 2021
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