Healthcare Provider Details

I. General information

NPI: 1659391688
Provider Name (Legal Business Name): MICHAEL SALINAS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 S CHICKASAW TRL
ORLANDO FL
32829-8366
US

IV. Provider business mailing address

6431 S CHICKASAW TRL
ORLANDO FL
32829-8366
US

V. Phone/Fax

Practice location:
  • Phone: 407-482-4800
  • Fax: 407-482-4811
Mailing address:
  • Phone: 407-482-4800
  • Fax: 407-482-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC3536
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPC3536
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: