Organization · Type 2 NPI
Ethereal Medspa LLC
Family Nurse Practitioner · Miami, FL
NPI number
1750182168
Active
Practice location
13011 SW 132nd St Ste B
Miami, FL 33186-7197
Mailing address
16894 SW 143rd Pl
Miami, FL 33177-2755
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
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About NPI 1750182168
Ethereal Medspa LLC's National Provider Identifier is 1750182168, issued on Mar 21, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Miami, FL. The record was last updated on Mar 21, 2025.