Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethereal Medspa LLC

Organization Family Nurse Practitioner · NPI 1750182168

Ethereal Medspa LLC is a Family Nurse Practitioner in Miami, Florida. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13011 SW 132nd St Ste B
Miami, FL 33186-7197
Phone: (786) 804-1241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1750182168
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Isabel Gomez Hernandez — Owner · (786) 804-1241
NPI enumeratedMarch 21, 2025
Last updated in NPPESMarch 21, 2025
Certification dateMarch 21, 2025
Mailing address16894 Sw 143rd Pl, Miami, FL 33177-2755

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