| LCA CASE NUMBER | I-200-21259-588336 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-16 |
| DECISION DATE | 2021-09-23 |
| 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 | 2022-02-01 |
| END DATE | 2025-01-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Hospital Physician Services Southeast, Professional Corporation |
| EMPLOYER ADDRESS1 | 265 Brookview Centre Way |
| EMPLOYER ADDRESS2 | Ste. 400 |
| EMPLOYER CITY | Knoxville |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37919 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18657696680 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Goins |
| EMPLOYER POC FIRST NAME | Tiffany |
| EMPLOYER POC JOB TITLE | Immigration Specialist |
| EMPLOYER POC ADDRESS1 | 265 Brookview Centre Way |
| EMPLOYER POC ADDRESS2 | Ste. 400 |
| EMPLOYER POC CITY | Knoxville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37919 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18657696680 |
| EMPLOYER POC EMAIL | tiffany_goins@teamhealth.com |
| 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 | rbus@breljelaw.com |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Brelje and Associates, PC |
|
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme Court of Texas |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | AdventHealth Altamonte Springs |
| WORKSITE ADDRESS1 | 601 E Altamonte Drive |
| LCA CASE WORKLOC1 CITY | Altamonte Springs |
| WORKSITE COUNTY | SEMINOLE |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 32701 |
| LCA CASE WAGE RATE FROM | 110 |
| LCA CASE WAGE RATE TO | 124.15 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 25.56 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B 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 | ksmith@breljelaw.com |
