| Name: | Peris Medical Corporation |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 30 Jan 2003 (22 years ago) |
| Date of Dissolution: | 17 Jun 2021 (4 years ago) |
| Date of Status Change: | 17 Jun 2021 (4 years ago) |
| Identification Number: | 000129700 |
| ZIP code: | 02907 |
| County: | Providence County |
| Principal Address: | 655 BROAD STREET 2ND FLOOR, PROVIDENCE, RI, 02907, USA |
| Purpose: | RENDERING PROFESSIONAL SERVICE AS A PHYSICIAN |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295952802 | 2007-04-18 | 2011-04-01 | 655 BROAD STREET, SUITE 201, PROVIDENCE, RI, 029071510, US | 655 BROAD STREET, SUITE 201, PROVIDENCE, RI, 029071510, US | |||||||||||||||||||||||
|
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| Phone | +1 401-383-6748 |
Authorized person
| Name | DR. EMILIO RODRIGUEZ-PERIS |
| Role | PROPIETOR |
| Phone | 4012266248 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD10391 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ER48067 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| EMILIO RODRIGUEZ-PERIS | Agent | 655 BROAD STREET 2ND FLOOR, PROVIDENCE, RI, 02907, USA |
| Name | Role | Address |
|---|---|---|
| EMILIO RODRIGUEZ-PERIS | PRESIDENT | 655 BROAD STREET 2ND FLOOR PROVIDENCE, RI 02907 USA |
| Number | Name | File Date |
|---|---|---|
| 202198399340 | Articles of Dissolution | 2021-06-17 |
| 202190156950 | Annual Report | 2021-02-04 |
| 202035462550 | Annual Report | 2020-02-26 |
| 201988718860 | Annual Report | 2019-03-15 |
| 201988692340 | Statement of Change of Registered/Resident Agent | 2019-03-15 |
| 201859047680 | Annual Report | 2018-02-23 |
| 201730495630 | Annual Report | 2017-01-19 |
| 201690294560 | Annual Report | 2016-01-08 |
| 201553099200 | Annual Report | 2015-01-12 |
| 201433916180 | Annual Report | 2014-01-21 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
