Provider Demographics
NPI:1821617853
Name:LO, ALEXANDER (DO, MPH, MS)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:DO, MPH, MS
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7975 LAKE UNDERHILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7975 LAKE UNDERHILL RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8204
Practice Address - Country:US
Practice Address - Phone:407-303-8683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21331207Q00000X, 204D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program