| 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 |
| Fictitious names: |
CENTRAL FALLS PRIMARY CARE (trading name, 2017-10-17 - ) |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720502008 | 2017-07-28 | 2017-10-31 | 1044 BROAD ST, CENTRAL FALLS, RI, 028631507, US | 1044 BROAD ST, CENTRAL FALLS, RI, 028631507, US | |||||||||||||||||||
|
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| 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
