| LCA CASE NUMBER | I-200-20219-754502 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-08-06 |
| DECISION DATE | 2022-03-03 |
| ORIGINAL CERT DATE | 2020-08-13 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1069 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-08-27 |
| END DATE | 2023-08-26 |
| TOTAL WORKER POSITIONS | 2 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 2 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | HNI Hospital Services of Florida, LLC |
| EMPLOYER ADDRESS1 | 7500 Rialto Blvd |
| EMPLOYER ADDRESS2 | Building 1; Suite 140 |
| EMPLOYER CITY | Austin |
| EMPLOYER STATE | TX |
| EMPLOYER POSTAL CODE | 78735 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17374840803 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Solis |
| EMPLOYER POC FIRST NAME | Rebecca |
| EMPLOYER POC JOB TITLE | General Counsel |
| EMPLOYER POC ADDRESS1 | 7500 Rialto Blvd |
| EMPLOYER POC ADDRESS2 | Building 1; Suite 140 |
| EMPLOYER POC CITY | Austin |
| EMPLOYER POC STATE | TX |
| EMPLOYER POC POSTAL CODE | 78735 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19568786074 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Bus |
| AGENT ATTORNEY FIRST NAME | Rachel |
| AGENT ATTORNEY MIDDLE NAME | I. |
| AGENT ATTORNEY ADDRESS1 | 3080 N. Litchfield Road |
| AGENT ATTORNEY CITY | Goodyear |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85395 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16235365750 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 2 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | Bay County Health System LLC d/b/a Ascension Sacre |
| WORKSITE ADDRESS1 | 615 N Bonita Ave |
| LCA CASE WORKLOC1 CITY | Panama City |
| WORKSITE COUNTY | BAY |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 32401 |
| LCA CASE WAGE RATE FROM | 279916 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Smith |
| PREPARER FIRST NAME | Kerri |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| PREPARER EMAIL | [email protected] |
