Individual provider Active NPI

Shely Blanco Ruiz

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1215820543
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-436882 Issued in FL
Practice address
11672 Fox Creek Dr
Tampa, FL 33635-1508
Phone
(813) 408-2081
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-436882 FL Primary

Addresses

Primary practice location

11672 Fox Creek Dr
Tampa, FL 33635-1508

Mailing address

11672 Fox Creek Dr
Tampa, FL 33635-1508
Phone (813) 408-2081

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
RBT-25-436882FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1215820543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11672 FOX CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336351508",
            "telephone_number": "813-408-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11672 FOX CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336351508",
            "telephone_number": "813-408-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO RUIZ",
        "first_name": "SHELY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-436882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.