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ETHEREAL MEDSPA LLC
NPI 1750182168
Nurse Practitioner - Family in Miami, FL

Active since March 21, 2025
13011 SW 132ND ST STE B, MIAMI, FL 33186(786) 804-1241 Get Directions Write a Review

NPPES record last updated: March 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethereal Medspa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHEREAL MEDSPA LLC (NPI 1750182168) is a healthcare organization registered as a family in Miami, Florida and active in the NPI registry since March 2025. The organization lists Isabel M Gomez Hernandez, Owner, as its authorized official.

NPPES Registry Identity

NPI1750182168
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameETHEREAL MEDSPA LLC
Location Address13011 SW 132ND ST STE BMiami, FL 33186-7197
Mailing Address16894 Sw 143rd PlMiami, FL 33177-2755 · (786) 804-1241
Phone(786) 804-1241
Organization SubpartNo
Authorized OfficialIsabel M Gomez HernandezOwner · (786) 804-1241
Enumeration DateMarch 21, 2025
NPPES CertifiedMarch 21, 2025
✔ NPI 1750182168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
13011 SW 132ND ST STE B, Miami, FL 33186
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethereal Medspa LLC's NPI number?

The NPI number for Ethereal Medspa LLC is 1750182168. It was assigned to this organization in the NPPES registry on March 21, 2025.

Where is Ethereal Medspa LLC located?

Ethereal Medspa LLC is located at 13011 SW 132nd St Ste B, Miami, FL 33186. The listed phone number is (786) 804-1241.

What is Ethereal Medspa LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Ethereal Medspa LLC was last updated on March 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.