Provider Demographics
NPI:1275972903
Name:ZORN, TRISTIN ANDREW (PTA)
Entity Type:Individual
Prefix:MR
First Name:TRISTIN
Middle Name:ANDREW
Last Name:ZORN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 CASEY KEY RD
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3394
Mailing Address - Country:US
Mailing Address - Phone:941-302-7786
Mailing Address - Fax:
Practice Address - Street 1:1803 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605
Practice Address - Country:US
Practice Address - Phone:813-247-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2013-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 24006225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant