Healthcare Provider Details

I. General information

NPI: 1124957709
Provider Name (Legal Business Name): PREMIER PRIVATE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 RIVER GROVE WAY APT 721
WEST PALM BEACH FL
33407-2187
US

IV. Provider business mailing address

195 RIVER GROVE WAY APT 721
WEST PALM BEACH FL
33407-2187
US

V. Phone/Fax

Practice location:
  • Phone: 920-659-2603
  • Fax:
Mailing address:
  • Phone: 920-659-2603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: SPENCER HERMUS
Title or Position: AMBR
Credential: PA-C
Phone: 920-659-2603