| LCA CASE NUMBER | I-200-21119-269294 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-29 |
| DECISION DATE | 2021-05-06 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Anesthesiologist Assistant |
| SOC CODE | 29-1071.01 |
| SOC TITLE | Anesthesiologist Assistants |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-02 |
| END DATE | 2024-08-01 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | H. Lee Moffitt Cancer Center and Research Institute Lifetime Cancer Screening Center, Inc. |
| TRADE NAME DBA | Moffitt Medical Group |
| EMPLOYER ADDRESS1 | 12902 USF Magnolia Drive |
| EMPLOYER ADDRESS2 | Mail Stop MTP-HR |
| EMPLOYER CITY | Tampa |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33612 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | FL |
| EMPLOYER PHONE | 18137450150 |
| NAICS CODE | 62231 |
| EMPLOYER POC LAST NAME | Bautista |
| EMPLOYER POC FIRST NAME | Johanna |
| EMPLOYER POC MIDDLE NAME | M. |
| EMPLOYER POC JOB TITLE | Immigration Specialist |
| EMPLOYER POC ADDRESS 1 | 12902 USF Magnolia Drive |
| EMPLOYER POC ADDRESS 2 | Mail Stop MTP-HR |
| EMPLOYER POC CITY | Tampa |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33612 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18137450150 |
| EMPLOYER POC EMAIL | Johanna.Bautista@moffitt.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Borovska |
| AGENT ATTORNEY FIRST NAME | Yova |
| AGENT ATTORNEY MIDDLE NAME | A. |
| AGENT ATTORNEY ADDRESS1 | 401 East Jackson Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2400 |
| AGENT ATTORNEY CITY | Tampa |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33602 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18132223341 |
| AGENT ATTORNEY EMAIL ADDRESS | margaret.reyes@bipc.com |
| LAWFIRM NAME BUSINESS NAME | Buchanan Ingersoll & Rooney PC |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 12902 USF Magnolia Drive |
| LCA CASE WORKLOC1 CITY | Tampa |
| WORKSITE COUNTY | HILLSBOROUGH |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 33612 |
| LCA CASE WAGE RATE FROM | 167835.2 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 105123 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| 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 | Reyes |
| PREPARER FIRST NAME | Margaret |
| PREPARER MIDDLE INITIAL | C. |
| PREPARER BUSINESS NAME | Buchanan Ingersoll & Rooney PC |
| PREPARER EMAIL | magaret.reyes@bipc.com |