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

Ethereal Medspa LLC

Organization Primary Care Nurse Practitioner · NPI 1841117611

Ethereal Medspa LLC is a Primary Care Nurse Practitioner in Miami, Florida. Registered with an NPI since 2026.

In the registry since
2026
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
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

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X

Record details

NPI number1841117611
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Isabel Gomez Hernandez — Aprn · (786) 804-1241
NPI enumeratedJuly 2, 2026
Last updated in NPPESJuly 14, 2026
Certification dateJuly 14, 2026
Mailing address13011 Sw 132nd St, Miami, FL 33186-7197

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