Individual provider Active NPI

Zyteldar Cobb Garzon, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1619664513
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18933 Issued in FL
Practice address
3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525
Phone
(833) 208-7770
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111221 TX
Clinical Social Worker 1041C0700X SW18933 FL Primary

Addresses

Primary practice location

3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525

Mailing address

2261 Amberly Ave
Orlando, FL 32833-3912
Phone (904) 864-3505

Other practice location 1

3109 W Mlk Blvd Ste 350
Tampa, FL 33607-6208
Phone (833) 208-7770

Other identifiers 2

IdentifierTypeStateIssuer
122027000MedicaidFL
1619664513MedicaidTX

Other names 1

  • Zyteldar Garzon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW18933FLMDClinical Social Worker
111221TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Imagine Pediatrics of Florida LLC PastSince Feb 11, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: zyteldar.cobb.garzon.1@27760.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1619664513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 AMBERLY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328333912",
            "telephone_number": "904-864-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTHWEST FWY STE 2100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277525",
            "telephone_number": "833-208-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3109 W Mlk Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076208",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBB GARZON",
        "first_name": "ZYTELDAR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111221",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122027000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619664513",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZYTELDAR",
            "last_name": "GARZON",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.