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  5. SKINPROS, LLC

SKINPROS, LLC

Company Details

Name: SKINPROS, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 19 Jul 2011 (14 years ago)
Identification Number: 000690499
ZIP code: 02904
County: Providence County
Principal Address: 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA
Purpose: MEDICAL DERMATOLOGY PRACTICE
NAICS: 621399 - Offices of All Other Miscellaneous Health Practitioners
Fictitious names: Ocean State Dermatology Associates (trading name, 2014-12-24 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1881966901 2012-02-05 2019-12-13 1287 N MAIN ST, PROVIDENCE, RI, 029041856, US 1287 N MAIN ST, PROVIDENCE, RI, 029041856, US

Contacts
Phone +1 401-272-2724
Fax 4012722784

Authorized person
Name DR. ANTONIO PAULINO CRUZ
Role OWNER/ MANAGER
Phone 4012433675

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number AC81611
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SKINPROS, LLC RETIREMENT PLAN 2021 452779165 2022-04-14 SKINPROS, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4012722724
Plan sponsor’s address 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904
SKINPROS, LLC RETIREMENT PLAN 2021 452779165 2022-04-18 SKINPROS, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4012722724
Plan sponsor’s address 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904
SKINPROS, LLC RETIREMENT PLAN 2020 452779165 2021-10-06 SKINPROS, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4012722724
Plan sponsor’s address 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904
SKINPROS, LLC RETIREMENT PLAN 2019 452779165 2020-10-02 SKINPROS, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4012722724
Plan sponsor’s address 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904
SKINPROS, LLC RETIREMENT PLAN 2018 452779165 2019-10-02 SKINPROS, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4012722724
Plan sponsor’s address 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Agent

Name Role Address
ANTONIO P. CRUZ Agent 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA

Filings

Number Name File Date
202445059960 Annual Report 2024-01-30
202326833700 Annual Report 2023-01-29
202216858130 Annual Report 2022-05-04
202101192440 Annual Report 2021-09-09
202064927510 Statement of Change of Registered/Resident Agent Office 2020-10-14
202062523930 Annual Report 2020-10-08
201924273280 Annual Report 2019-10-15
201876855840 Annual Report 2018-09-07
201752481860 Annual Report 2017-10-30
201608896150 Annual Report 2016-09-15

Related by officers

ANTONIO P. CRUZ

MINDSPRAY INITIATIVES, LLC

Related by address

1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA

MINDSPRAY INITIATIVES, LLC MOHSPROS, LLC MINDSPRAY INITIATIVES SOUTH LLC Dermatology Logistics, LLC

Date of last update: 16 Oct 2024

Sources: Rhode Island Department of State

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