| Doctor Name: | MR. RICKY K LO |
| NPI Number: | 1003865544 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA9102314 |
| Business Practice Address: | 6550 N Federal Hwy Suite 512 Ft Lauderdale, FL - 333081404 |
| Business Phone Number: | 6153455581 |
| Business Fax Number: | 6153455565 |
| Mailing Address: | 3100 West End Ave, Suite 800 NASHVILLE |
| State: | TN |
| Postal Code: | 372031320 |
| Phone Number: | 6153455581 |
| Fax Number: | 6153455565 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 09/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA9102314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |