MIRTHA BLANC — NPI 1306534334 (Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging in RUSKIN, FL)

CMS-1500 Box 24J / 33a • NPI

1306534334

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TA0700X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging

Box 32 Service Location & ZIP+4

1513 CLIMBING DAYFLOWER DR, RUSKIN, FL, 33570-4948

✓ 9-Digit EDI 837 ZIP+4 (33570-4948)

Practice Phone & Referral Fax

(813) 733-1726

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306534334 (MIRTHA BLANC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1306534334` (NPI-1 Individual Practitioner)
Provider / Legal Name	MIRTHA BLANC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging NUCC Code: `103TA0700X` (Psychologist, Adult Development & Aging)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1513 CLIMBING DAYFLOWER DR, RUSKIN, FL, 33570-4948
Practice Telephone / Fax	Tel: (813) 733-1726
Administrative Mailing Address	1513 CLIMBING DAYFLOWER DR, RUSKIN, FL, 33570-4948
Enumeration & Last Sync	Enumerated: 2023-04-27 \| CMS Record Updated: 2023-04-27

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1513 CLIMBING DAYFLOWER DR, RUSKIN, FL, 33570-4948

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Plain-English Taxonomy & CMS Crosswalk (103TA0700X)

What Does Taxonomy Code 103TA0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TA0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Adult Development & Aging for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MIRTHA BLANC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103TA0700X` — Psychologist, Adult Development & Aging Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging	State: FL \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MIRTHA BLANC (NPI #1306534334)