| CASE NUMBER | I-200-23298-456151 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/25/2023 |
| DECISION DATE | 11/1/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician Assistant |
| SOC CODE | 29-1071.00 |
| SOC TITLE | Physician Assistants |
| FULL TIME POSITION | Y |
| BEGIN DATE | 4/13/2024 |
| END DATE | 4/12/2027 |
| 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 | SHANDS TEACHING HOSPITAL AND CLINICS, INC. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1600 SW ARCHER ROAD |
| EMPLOYER ADDRESS2 | P.O. BOX 100303 |
| EMPLOYER CITY | GAINESVILLE |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 32610-0303 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 13526279045 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | SUAREZ-RINCON |
| EMPLOYER POC FIRST NAME | Paola |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Paralegal |
| EMPLOYER POC ADDRESS1 | 201 S. E. 2nd Avenue, Suite 209 |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Gainesville |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 32601 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 13526279045 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | psua0001@shands.ufl.edu |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | NORTELUS |
| AGENT ATTORNEY FIRST NAME | Anielka |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 800 NW 62ND AVENUE |
| AGENT ATTORNEY ADDRESS2 | SUITE 590 |
| AGENT ATTORNEY CITY | MIAMI |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33126 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13057745800 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | FRAGOMENUNIVERSITYTEAM@FRAGOMEN.COM |
| LAWFIRM NAME BUSINESS NAME | Fragomen, Del Rey, Bernsen, & Loewy, 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 | 1600 S.W. Archer Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Gainesville |
| WORKSITE COUNTY | ALACHUA |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 32608 |
| WAGE RATE OF PAY FROM | 109990 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $109,991.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $72,883.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | P-200-23088-887517 |
| PW WAGE LEVEL | |
| PW OES YEAR | |
| 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 | 2025-01-04 |
