DEAISA BOMORT

Driver

NPI: 1558035717Individual

Specialties, Licenses & Credentials

DriverPrimary

Driver

Code: 172A00000X

B563179949530(FL)

Contact & Hours

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

Quick Facts

NPI: 1558035717
Entity Type: Individual
Gender: Female
Medicare: Not confirmed
Specialties: 1
Locations: 1

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