Healthcare Provider Details

I. General information

NPI: 1164938221
Provider Name (Legal Business Name): ZAIMARA RODRIGUEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 LEXINGTON DR
BARKSDALE AFB LA
71110-2170
US

IV. Provider business mailing address

2215 LEXINGTON DR
BARKSDALE AFB LA
71110-2170
US

V. Phone/Fax

Practice location:
  • Phone: 407-334-2807
  • Fax:
Mailing address:
  • Phone: 407-334-2807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: