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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