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Organization
PREMIER INTERVENTIONAL AND DIAGNOSTIC RADIOLOGY CORP
Active
Organization
PREMIER INTERVENTIONAL AND DIAGNOSTIC RADIOLOGY CORP
Active
Other names
Premier Vascular and Interventional
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILIO LOPEZ M.D. (AUTHORIZED OFFICIAL/OWNER)
(786) 547-7655
Entity
Organization
Contact information
Practice address
7556 LAKE WORTH RD STE 103, LAKE WORTH, FL 33467-2503
(561) 894-1370
(561) 894-1372
Mailing address
7556 LAKE WORTH RD STE 103, LAKE WORTH, FL 33467-2503
(561) 894-1370
(561) 894-1372
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104439200
—
FL
Enumeration date
09/30/2019
Last updated
02/09/2026
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