| LCA CASE NUMBER | I-200-21174-421517 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-23 |
| DECISION DATE | 2021-06-30 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | SURGERY PHYSICIAN ASSISTANT |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-01 |
| END DATE | 2024-07-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | ADMINISTRACION DE SERVICIOS MEDICOS DE PUERTO RICO INC. |
| TRADE NAME DBA | SCHOOL OF MEDICINE UNIVERSITY OF PUERTO RICO |
| EMPLOYER ADDRESS1 | CENTRO MEDICO BARRIO MONACILLOS CARR 22 |
| EMPLOYER CITY | SAN JUAN |
| EMPLOYER STATE | PR |
| EMPLOYER POSTAL CODE | 935 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17877773535 |
| NAICS CODE | 561110 |
| EMPLOYER POC LAST NAME | RODRIGUEZ MERCADO |
| EMPLOYER POC FIRST NAME | RAFAEL |
| EMPLOYER POC JOB TITLE | PROFESSOR NEUROSURGERY |
| EMPLOYER POC ADDRESS 1 | PO BOX 363185 |
| EMPLOYER POC CITY | SAN JUAN |
| EMPLOYER POC STATE | PR |
| EMPLOYER POC POSTAL CODE | 00936 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17874032989 |
| EMPLOYER POC EMAIL | RAFAEL.RODRIGUEZ18@UPR.EDU |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | SCALLEY |
| AGENT ATTORNEY FIRST NAME | KAREN |
| AGENT ATTORNEY MIDDLE NAME | MARIE |
| AGENT ATTORNEY ADDRESS1 | 239 ARTERIAL HOSTOS CAPITAL CENTER I |
| AGENT ATTORNEY ADDRESS2 | SUITE 302 |
| AGENT ATTORNEY CITY | SAN JUAN |
| AGENT ATTORNEY STATE | PR |
| AGENT ATTORNEY POSTAL CODE | 918 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17877512510 |
| AGENT ATTORNEY EMAIL ADDRESS | KSCALLEY@KSIMMIGRATION.COM |
| LAWFIRM NAME BUSINESS NAME | KS IMMIGRATION SOLUTIONS |
| STATE OF HIGHEST COURT | PR |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | CENTRO MEDICO BARRIO MONACILLOS CARR 22 |
| LCA CASE WORKLOC1 CITY | SAN JUAN |
| WORKSITE COUNTY | SAN JUAN |
| LCA CASE WORKLOC1 STATE | PR |
| WORKSITE POSTAL CODE | 935 |
| LCA CASE WAGE RATE FROM | 89090 |
| LCA CASE WAGE RATE TO | 120000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 87090 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| 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 | SCALLEY |
| PREPARER FIRST NAME | KAREN |
| PREPARER MIDDLE INITIAL | M |
| PREPARER BUSINESS NAME | KS IMMIGRATION SOLUTIONS |
| PREPARER EMAIL | KSCALLEY@KSIMMIGRATION.COM |
