MEDICARE: NEW WAY MED SPA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1164319349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW WAY MED SPA, LLC

Provider Business Mailing Address
First Line	:	312 NAVY BLVD
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-4902
Country	:	US
Telephone Number	:	850-775-4498
Fax Number	:	850-775-4247

Provider Business Practice Location Address
First Line	:	312 THOMAS DR
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-4902
Country	:	US
Telephone Number	:	850-775-4498
Fax Number	:	850-775-4247

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN TAYES
Credential	:	APRN
Telephone Number	:	850-775-4498

Provider Enumeration Date	:	06/20/2025
Last Update Date	:	09/26/2025

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Directions to “NEW WAY MED SPA, LLC ” Practice Location

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