Healthcare Provider Details

I. General information

NPI: 1164319349
Provider Name (Legal Business Name): NEW WAY MED SPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 THOMAS DR
PANAMA CITY BEACH FL
32408-4902
US

IV. Provider business mailing address

312 NAVY BLVD
PANAMA CITY BEACH FL
32408-4902
US

V. Phone/Fax

Practice location:
  • Phone: 850-775-4498
  • Fax: 850-775-4247
Mailing address:
  • Phone: 850-775-4498
  • Fax: 850-775-4247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAREN TAYES
Title or Position: OWNER
Credential: APRN
Phone: 850-775-4498