| CASE NUMBER | I-200-24184-166576 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/1/2024 |
| DECISION DATE | 7/9/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician |
| SOC CODE | 29-1299.00 |
| SOC TITLE | Healthcare Diagnosing or Treating Practitioners, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/1/2024 |
| END DATE | 8/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Florida Hospital Physician Group, Inc. |
| TRADE NAME DBA | AdventHealth Medical Group General Surgery At Tampa |
| EMPLOYER ADDRESS1 | 12470 Telecom Drive |
| EMPLOYER ADDRESS2 | Suite 100 |
| EMPLOYER CITY | Tampa |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33637 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +14073571626 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Colon Negron |
| EMPLOYER POC FIRST NAME | Anna |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Senior Manager, Corporate International Recruitment -HR |
| EMPLOYER POC ADDRESS1 | 900 HOPE WAY |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Altamonte Springs |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 32714 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +14077331060 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ANNA.COLONNEGRON@ADVENTHEALTH.COM |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | GAVICA PEREZ |
| AGENT ATTORNEY FIRST NAME | DENISE |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 98 SE 7 STREET |
| AGENT ATTORNEY ADDRESS2 | SUITE 1100 |
| AGENT ATTORNEY CITY | MIAMI |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33131 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +13059825638 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | JESSICA.TRUJILLO@AKERMAN.COM |
| LAWFIRM NAME BUSINESS NAME | AKERMAN LLP |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3000 Medical Park Dr. |
| WORKSITE ADDRESS2 | Suite 500 |
| WORKSITE CITY | Tampa |
| WORKSITE COUNTY | HILLSBOROUGH |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 33613 |
| WAGE RATE OF PAY FROM | 62,005.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $53,747.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-09 |
