| Name: | Advanced Dermatology of Rhode Island, PC |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Mar 2017 (8 years ago) |
| Identification Number: | 001671840 |
| Principal Address: | 151 SOUTHHALL LANE STE. 300, MAITLAND, FL, 32751, USA |
| Purpose: | DERMATOLOGY AND COSMETIC SURGERY |
| Fictitious names: |
Advanced Dermatology and Cosmetic Surgery (trading name, 2021-04-08 - ) |
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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386185759 | 2017-03-17 | 2017-03-17 | 151 SOUTHHALL LN, SUITE 300, MAITLAND, FL, 327517176, US | 1351 S COUNTY TRL, SUITE 302, EAST GREENWICH, RI, 028185105, US | |||||||||||||||
|
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| Phone | +1 407-875-2080 |
| Phone | +1 401-886-5663 |
Authorized person
| Name | DAVID MORELL |
| Role | PRESIDENT |
| Phone | 4078752080 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Name | Role | Address |
|---|---|---|
| MATT LEAVITT | PRESIDENT | 151 SOUTHHALL LANE, STE. 300 MAITLAND, FL 32751 USA |
| Name | Role | Address |
|---|---|---|
| MATT LEAVITT | TREASURER | 151 SOUTHHALL LANE, STE. 300 MAITLAND, FL 32751 USA |
| Name | Role | Address |
|---|---|---|
| MATT LEAVITT | SECRETARY | 151 SOUTHHALL LANE, STE. 300 MAITLAND, FL 32751 USA |
| Name | Role | Address |
|---|---|---|
| MATT LEAVITT | DIRECTOR | 151 SOUTHHALL LANE, STE. 300 MAITLAND, FL 32751 USA |
| Number | Name | File Date |
|---|---|---|
| 202455755030 | Annual Report | 2024-06-14 |
| 202333400470 | Annual Report | 2023-04-20 |
| 202215065070 | Annual Report | 2022-04-19 |
| 202100031380 | Statement of Change of Registered/Resident Agent | 2021-08-06 |
| 202195594720 | Fictitious Business Name Statement | 2021-04-08 |
| 202191554250 | Annual Report | 2021-02-17 |
| 202034459470 | Annual Report | 2020-02-14 |
| 201990933150 | Statement of Change of Registered/Resident Agent | 2019-04-23 |
| 201988651310 | Annual Report | 2019-03-14 |
| 201878835480 | Annual Report | 2018-10-03 |
Date of last update: 26 Oct 2024
Sources: Rhode Island Department of State
