Individual
MR. RICKY K LO
Active
Individual
MR. RICKY K LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U1473
MEDICARE PTAN
FL
Enumeration date
05/10/2006
Last updated
08/10/2022
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