| Name: | CENTERVILLE PODIATRY, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 09 May 2011 (14 years ago) |
| Date of Dissolution: | 14 Feb 2022 (3 years ago) |
| Date of Status Change: | 14 Feb 2022 (3 years ago) |
| Identification Number: | 000660931 |
| ZIP code: | 02886 |
| County: | Kent County |
| Principal Address: | 469 CENTERVILLE ROAD #105, WARWICK, RI, 02886, USA |
| Purpose: | PODIATRY OFFICE |
| NAICS: | 621391 - Offices of Podiatrists |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871041491 | 2016-09-12 | 2016-09-12 | 469 CENTERVILLE RD, STE 105, WARWICK, RI, 028864354, US | 469 CENTERVILLE RD, STE 105, WARWICK, RI, 028864354, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 401-738-9200 |
| Fax | 4017389400 |
Authorized person
| Name | DR. GEORGE M MONIZ |
| Role | OWNER |
| Phone | 4017389200 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| License Number | DPM277 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| License Number | DPM208 |
| State | RI |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JOHN E. BUCCI, JR. | Agent | 2181 POST ROAD, WARWICK, RI, 02886, USA |
| Number | Name | File Date |
|---|---|---|
| 202210254370 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-02-14 |
| 202106425930 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202066151940 | Annual Report | 2020-10-19 |
| 201917891880 | Annual Report | 2019-09-06 |
| 201879739840 | Annual Report | 2018-10-19 |
| 201751566180 | Annual Report | 2017-10-14 |
| 201609435060 | Annual Report | 2016-09-27 |
| 201600646690 | Annual Report | 2016-06-14 |
| 201600647930 | Statement of Change of Registered/Resident Agent | 2016-06-14 |
| 201600650570 | Annual Report | 2016-06-14 |
Date of last update: 15 Oct 2024
Sources: Rhode Island Department of State
