Provider Demographics
NPI:1184949828
Name:GAL, OMER (MD)
Entity type:Individual
Prefix:DR
First Name:OMER
Middle Name:
Last Name:GAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 W GREEN TREE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2806
Mailing Address - Country:US
Mailing Address - Phone:917-287-5186
Mailing Address - Fax:
Practice Address - Street 1:348 MIRACLE STRIP PKWY SW STE 38
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-5264
Practice Address - Country:US
Practice Address - Phone:850-346-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 116385207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology