MEDICARE: PREMIER PRIVATE HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1124957709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER PRIVATE HEALTH PLLC

Provider Business Mailing Address
First Line	:	195 RIVER GROVE WAY APT 721
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2187
Country	:	US
Telephone Number	:	920-659-2603
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 RIVER GROVE WAY APT 721
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2187
Country	:	US
Telephone Number	:	920-659-2603
Fax Number	:

Authorized Official
Title or Position	:	AMBR
Name	:	SPENCER HERMUS
Credential	:	PA-C
Telephone Number	:	920-659-2603

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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