Provider Demographics
NPI:1144107947
Name:PREMIER RNA LLC
Entity type:Organization
Organization Name:PREMIER RNA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANAYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIVES FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-980-3295
Mailing Address - Street 1:5550 SHADDELEE LN W
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-2527
Mailing Address - Country:US
Mailing Address - Phone:239-980-3295
Mailing Address - Fax:
Practice Address - Street 1:5550 SHADDELEE LN W
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-2527
Practice Address - Country:US
Practice Address - Phone:239-980-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty