| LCA CASE NUMBER | I-200-22168-293810 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2022-06-17 |
| DECISION DATE | 2022-06-27 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatric Heart Failure and Transplantation Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-11-04 |
| END DATE | 2025-11-03 |
| 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 | SOUTH BROWARD HOSPITAL DISTRICT |
| TRADE NAME DBA | MEMORIAL HEALTHCARE SYSTEM |
| EMPLOYER ADDRESS1 | 3111 STIRLING ROAD |
| EMPLOYER CITY | HOLLYWOOD |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33312 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19549855972 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Primiano |
| EMPLOYER POC FIRST NAME | Angela |
| EMPLOYER POC JOB TITLE | Vice President, Human Resources |
| EMPLOYER POC ADDRESS1 | 3111 STIRLING ROAD |
| EMPLOYER POC CITY | HOLLYWOOD |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33312 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19542657778 |
| EMPLOYER POC EMAIL | APrimiano@mhs.net |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | OMBOK |
| AGENT ATTORNEY FIRST NAME | OTIENO |
| AGENT ATTORNEY MIDDLE NAME | B |
| AGENT ATTORNEY ADDRESS1 | 44 SOUTH BROADWAY |
| AGENT ATTORNEY ADDRESS2 | 14TH FLOOR |
| AGENT ATTORNEY CITY | WHITE PLAINS |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10601 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19148726895 |
| AGENT ATTORNEY EMAIL ADDRESS | Otieno.Ombok@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | JACKSON LEWIS PC |
|
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | Joe DiMaggio Children’s Hospital |
| WORKSITE ADDRESS2 | 1005 Joe DiMaggio Dr. |
| LCA CASE WORKLOC1 CITY | Hollywood |
| WORKSITE COUNTY | BROWARD |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 33021 |
| LCA CASE WAGE RATE FROM | 257501 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 214386 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | NAZAROVA |
| PREPARER FIRST NAME | NATALIA |
| PREPARER MIDDLE INITIAL | V |
| PREPARER BUSINESS NAME | JACKSON LEWIS PC |
| PREPARER EMAIL | NATALIA.NAZAROVA@JACKSONLEWIS.COM |
