# KRAYSSA SURGICAL ASSIST, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104274760
- **Authorized official:** WATFA KRAYSSA PAC (PRESIDENT/CEO)
- **Authorized official phone:** (954) 648-7850

## Contact information

- **Practice address:** 601 NW 82ND AVE APT 331, PLANTATION, FL 33324-1397
- **Practice address phone:** (954) 648-7850
- **Mailing address:** 601 NW 82ND AVE APT 331, PLANTATION, FL 33324-1397
- **Mailing address phone:** (954) 648-7850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | PA9104341 | FL | — |
| 363AS0400X | Surgical Physician Assistant | PA9104341 | FL | Yes |

## Other

- **Enumeration date:** 05/24/2016
- **Last updated:** 05/24/2016