| 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 |
| Fictitious names: |
Ocean State Dermatology Associates (trading name, 2014-12-24 - ) |
NAICS
621399 Offices of All Other Miscellaneous Health PractitionersThis U.S. industry comprises establishments of independent health practitioners (except physicians; dentists; chiropractors; optometrists; mental health specialists; physical, occupational, and speech therapists; audiologists; and podiatrists). 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 | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881966901 | 2012-02-05 | 2019-12-13 | 1287 N MAIN ST, PROVIDENCE, RI, 029041856, US | 1287 N MAIN ST, PROVIDENCE, RI, 029041856, US | |||||||||||||||||||||
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| 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 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SKINPROS, LLC RETIREMENT PLAN | 2021 | 452779165 | 2022-04-14 | SKINPROS, LLC | 20 | |||||||||||||
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| SKINPROS, LLC RETIREMENT PLAN | 2021 | 452779165 | 2022-04-18 | SKINPROS, LLC | 21 | |||||||||||||
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| SKINPROS, LLC RETIREMENT PLAN | 2020 | 452779165 | 2021-10-06 | SKINPROS, LLC | 20 | |||||||||||||
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| SKINPROS, LLC RETIREMENT PLAN | 2019 | 452779165 | 2020-10-02 | SKINPROS, LLC | 18 | |||||||||||||
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| SKINPROS, LLC RETIREMENT PLAN | 2018 | 452779165 | 2019-10-02 | SKINPROS, LLC | 16 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| ANTONIO P. CRUZ | Agent | 1287 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA |
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3840937107 | 2020-04-12 | 0165 | PPP | 1287 N. MAIN ST, PROVIDENCE, RI, 02904-1856 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 16 Oct 2024
Sources: Rhode Island Department of State
