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CENTERVILLE PODIATRY, LLC

Company Details

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
Purpose: PODIATRY OFFICE
Principal Address: Google Maps Logo 469 CENTERVILLE ROAD #105, WARWICK, RI, 02886, USA

Industry & Business Activity

NAICS

621391 Offices of Podiatrists

This U.S. industry comprises establishments of health practitioners having the degree of D.P.M. (Doctor of Podiatric Medicine) primarily engaged in the independent practice of podiatry. These practitioners diagnose and treat diseases and deformities of the foot and 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

Agent

Name Role Address
JOHN E. BUCCI, JR. Agent 2181 POST ROAD, WARWICK, RI, 02886, USA

National Provider Identifier

NPI Number:
1871041491

Authorized Person:

Name:
DR. GEORGE M MONIZ
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary:
No
Selected Taxonomy:
213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary:
Yes

Contacts:

Fax:
4017389400

Filings

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

Date of last update: 30 May 2025

Sources: Rhode Island Department of State