| NPI | 1104274760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WATFA KRAYSSA President/CEO 954-648-7850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104341) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104341) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |