Individual
MR. WALID MANGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1050 SE MONTEREY ROAD, SUITE #104, FLORIDA VISION INSTITUTE INC., STUART, FL 34994
(772) 283-2020
(772) 219-7924
Mailing address
1050 SE MONTEREY ROAD, SUITE #104, FLORIDA VISION INSTITUTE INC., STUART, FL 34994
(772) 283-2020
(772) 219-7924
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0102203133
VA
207W00000X
Ophthalmology Physician
H0074109
MD
207W00000X
Ophthalmology Physician
OS12479
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
OS12479
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0552984 01
—
MD
05
—
1659529055
—
VA
Enumeration date
08/28/2008
Last updated
05/05/2017
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