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Organization

JOANNETTE SALAS OD AND ASSOCIATES PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RANDI WOERNER (PROFESSIONAL RELATIONS MANAGER)
(856) 228-1000
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPC3633
OPTOMETRIST LICENSE
FL
Enumeration date
02/04/2022
Last updated
09/19/2022
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