Provider Demographics
NPI:1962008789
Name:ROBBINS, ZACHARY CALEB (PTA)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CALEB
Last Name:ROBBINS
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 1:5761 HERMITAGE CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-8749
Mailing Address - Country:US
Mailing Address - Phone:850-525-7381
Mailing Address - Fax:
Practice Address - Street 1:8475 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-4917
Practice Address - Country:US
Practice Address - Phone:850-474-1252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30491225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant