Individual provider Active NPI

Dargel Rodriguez Mederos

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1174065726
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11039003 Issued in FL
Practice address
13207 SW 44TH LN
Miami, FL 33175-3934
Phone
(786) 245-1687
NPI assigned
Nov 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11039003 FL Primary

Addresses

Primary practice location

13207 SW 44TH LN
Miami, FL 33175-3934

Mailing address

13207 SW 44TH LN
Miami, FL 33175-3934
Phone (786) 245-1687

Other identifiers 1

IdentifierTypeStateIssuer
019517000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250906000442 FL Practitioner - Nurse Practitioner 8729580907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11039003FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellbeing LLC CurrentSince Sep 15, 2025 Accepting new patients
R&D Empowering Minds Corp Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients

Locations

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1174065726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13207 SW 44TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753934",
            "telephone_number": "786-245-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13207 SW 44TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753934",
            "telephone_number": "786-245-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MEDEROS",
        "first_name": "DARGEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-14",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11039003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019517000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.