| CASE NUMBER | I-200-23297-452294 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/24/2023 |
| DECISION DATE | 10/31/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | PHYSICIAN |
| SOC CODE | 29-1215.00 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 4/5/2024 |
| END DATE | 4/4/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | BAYCARE MEDICAL GROUP |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 3503 E. FRONTAGE RD. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | TAMPA |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33607 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18135868188 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | ROGERS |
| EMPLOYER POC FIRST NAME | APRIL |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | PHYSICIAN RECRUITER |
| EMPLOYER POC ADDRESS1 | 3503 E. FRONTAGE RD. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | TAMPA |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33607 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18135868188 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | APRIL.ROGERS@BAYCARE.ORG |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | BRADSHAW |
| AGENT ATTORNEY FIRST NAME | PENNI |
| AGENT ATTORNEY MIDDLE NAME | PEARSON |
| AGENT ATTORNEY ADDRESS1 | ONE WEST 4TH ST. |
| AGENT ATTORNEY ADDRESS2 | STE. 850 |
| AGENT ATTORNEY CITY | WINSTON-SALEM |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27101 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13367216842 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ABRANNON@CONSTANGY.COM |
| LAWFIRM NAME BUSINESS NAME | CONSTANGY, BROOKS, SMITH & PROPHETE, LLP |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2529 CYPRESS RIDGE BLVD. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | WESLEY CHAPEL |
| WORKSITE COUNTY | PASCO |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 33544 |
| WAGE RATE OF PAY FROM | 180814 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $241,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $180,814.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | BRANNON |
| PREPARER FIRST NAME | AIMEE |
| PREPARER MIDDLE INITIAL | D |
| PREPARER BUSINESS NAME | CONSTANGY BROOKS SMITH & PROPHETE LLP |
| PREPARER EMAIL | abrannon@constangy.com |
| BEGIN DATE CONVERTED | 2024-05-04 |
