# JOANNETTE SALAS OD AND ASSOCIATES PA

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

## Provider details

- **NPI number:** 1376297861
- **Authorized official:** MRS. RANDI WOERNER (PROFESSIONAL RELATIONS MANAGER)
- **Authorized official phone:** (856) 228-1000

## Contact information

- **Practice address:** 1311 E MICHIGAN ST, ORLANDO, FL 32806-4814
- **Practice address phone:** (407) 843-3533
- **Mailing address:** 1 HARMON DR, BLACKWOOD, NJ 08012-5103
- **Mailing address phone:** (856) 228-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2022
- **Last updated:** 09/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | OPC3633 | OPTOMETRIST LICENSE | FL |