| Name: | Ernesto Mirabal, M.D., LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 26 Apr 2017 (8 years ago) |
| Identification Number: | 001673204 |
| ZIP code: | 02863 |
| County: | Providence County |
| Principal Address: | 1002 BROAD ST SUITE 1, CENTRAL FALLS, RI, 02863, USA |
| Purpose: | TO RENDER PROFESSIONAL MEDICAL SERVICES |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
CENTRAL FALLS PRIMARY CARE (trading name, 2017-10-17 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720502008 | 2017-07-28 | 2017-10-31 | 1044 BROAD ST, CENTRAL FALLS, RI, 028631507, US | 1044 BROAD ST, CENTRAL FALLS, RI, 028631507, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 401-226-8716 |
| Phone | +1 401-722-4086 |
Authorized person
| Name | DR. ERNESTO ANTONIO MIRABAL |
| Role | MD |
| Phone | 4012268716 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD11356 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ERNESTO MIRABAL | Agent | 1002 BROAD STREET SUITE 3, CENTRAL FALLS, RI, 02863, USA |
| Number | Name | File Date |
|---|---|---|
| 202455412780 | Annual Report | 2024-06-06 |
| 202327913870 | Annual Report | 2023-02-09 |
| 202213410980 | Annual Report | 2022-03-24 |
| 202100519310 | Annual Report | 2021-08-30 |
| 202057048710 | Annual Report | 2020-09-23 |
| 201924449360 | Annual Report | 2019-10-17 |
| 201882009370 | Annual Report | 2018-11-30 |
| 201882010150 | Statement of Change of Registered/Resident Agent Office | 2018-11-30 |
| 201751731740 | Fictitious Business Name Statement | 2017-10-17 |
| 201741735480 | Articles of Organization | 2017-04-26 |
Date of last update: 26 Oct 2024
Sources: Rhode Island Department of State
