approved facilities 4-07-15 · 6830 pines blvd, pembroke pines, fl 33024 1609 e vine st, kissimmee,...

Facilities Approved as Areas of Critical Need

4/07/2015

COUNTY FACILITY NAME FACILITY ADDRESS PHONE# DATE APPR.

Method of Approval

Alachua ACORN Clinic 23320 N. State Road 235, Brooker, FL 32622 (352)485-1133 2/5/02 Secretary Alachua Alachua County Health Department

- Alachua Clinic - Family Services Center - Hawthorne Clinic - High Springs Clinic - Newberry Clinic

730 NE Waldo Rd, Gainesville, FL 32641 13630 N. W. 151 Place, Alachua, FL 32641 3600 N. E. 15 Street, Gainesville, FL 32609 22000 S. E. 65 Ave., Hawthorne, FL 32640 30 S. W. First Avenue, High Springs, FL 32643 25435 W. Newberry Road, Newberry, FL 32669

352-955-2356 386-462-2542 352-955-7220 352-481-2388 386-454-2421 352-472-1160

CHD

Alachua Helping Hands Clinic, Inc. First United Methodist Church, 419 NE 1st St, Gainesville, FL 32601

352-372-8523 10/07 VHCPP

Alachua Eftim Adhami, M.D., Lupus Foundation of Gainesville

945 NW 114th Way, Gainesville, FL 32606 352-275-8171 6/23/09 Secretary

Alachua Westside Samaritans Clinic 10000 W. Newberry Road, Gainesville, FL 32606 352-333-7700 x113

05/17/12 SSG

Alachua The Primary Care Clinic of Gainesville, PA 1026-C SW 2nd Avenue, Gainesville, FL 32601 352-284-3669 08/10/12 SSG Alachua North Florida Evaluation and Treatment Center 1200 NE 55th Blvd., Gainesville, FL 32641 08/26/13 SSG Alachua Tacachale Developmental Disability Center 1621 NE Waldo Rd, Gainesville, FL 32609 352-955-5000 2/26/201

4Auto

Alachua Med Family Care, PLLC 3600 Northwest 43rd Street, Gainesville, FL 32606 04/23/14 SSG Alachua Samaritan OBGYN 1201 Northwest 64th Terrace, Gainesville, FL 32605 05/05/14

02/26/1503/17/15

SSG

Alachua University of Florida Mobile Outreach Clinic 1600 S W Archer Rd, Ste. NG3, Gainesville, FL32610 07/11/14 SSG Alachua North Florida Woman Care DBA Samaritan

OBGYN 1201 Northwest 64th Terrace Gainesville, Florida 32605

03/31/15 SSG

Baker Baker County Health Department 480 West Lowder Street, Macclenny, FL 32063 904-259-6291 07/22/14 CHD Bay Bay County Council of Aging 1116 Frankford Ave., Panama City, FL 32401 904-769-3468 4/9/94 VHCPP Bay St. Andrews Community Medical Center 1616 Cincinnati Ave., Panama City, FL 32401 850-785-1419 6/5/04 VHCPP Bay Bay County Health Department 597 W. 11th St., Panama City, FL 32401 850-872-4455 CHD Bay PanCare of Florida, Inc. DBA Community

Health Center – Bay County 707-A Jenks Avenue, Panama City, FL 32401 (dental only) 2309 E 15th St, Panama City (Cedar Grove), FL 32405

850-872-4128 s. 330

Bay Gulf Coast Holistic and Primary Care 756 Harrison Avenue, Panama City, FL 32401 05/28/13 SSG Bay Bernier Family Practice DBA Emerald Medical

Center 1606 Tennessee Ave., Lynn Haven, FL 32444 10/21/14 SSG

Bradford Bradford County Health Department 1801 North Temple Ave. Starke, FL 32091 904-964-7732 CHD Brevard Brevard Health Alliance 270 Babcock Street NE, #1, Palm Bay, FL 32905 321-733-2021 s. 330


4/07/2015


Method of Approval

Brevard Brevard County Health Department - Melbourne Clinic, Melbourne - PATH Clinic, Rockledge - Rockledge Clinic, Rockledge - Titusville Clinic, Titusville

2575 N. Courtenay Pkwy, Merritt Island, FL 32953-4147 2275 S. Babcock St., Melbourne, FL 32901 1744 Cedar St., Rockledge, FL 32955 1744 Cedar St., Rockledge, FL 32955 611 Singleton Av., Titusville, FL 32796

407-454-7111 321-726-2920 321-690-6494 321-634-6305 321-383-2795

4/8/94 CHD

Brevard Brevard County Jail 860 Camp Road, Cocoa, FL 32927 321-690-1500 05/02/12 SSG Brevard George Idiculla, M.D., P.A. Internal Medicine 1029 South Florida Avenue, Rockledge, FL 32955 321-638-0888 10/30/12 SSG Broward Broward Community & Family Health Centers,

Inc. -Thomas N. Anthony Medical Center -Broward Community & Family Health

2518 N. SR 7, Hollywood, FL 33021 188 N. Powerline Rd, Pompano Beach, FL 33026

954-967-0028 954-970-8805

s. 330

Broward Broward County Health Department - Ft. Lauderdale Health Center - Hughes Health Center - North Regional Public Health Center - Northwest Health Center - South Regional Health Center - Sunrise Health Center

2421-A SW 6th Ave., Ft. Lauderdale, FL 33115-2613 205 NE 6th Ave., Pompano Beach, FL 33060 601 W. Atlantic Blvd., Pompano Bch, FL 33060 624 NW 15 Way, Ft. Lauderdale, FL 33311 4105 Pembroke Rd., Hollywood, FL 33020 900 NW 31st Ave., Ft. Lauderdale, FL 33311

954-467-4938 954-788-6140 954-467-4531 954-985-4800 954-327-6000

CHD

Broward Project Access 8000 Biscayne Blvd, Miami, FL 33138 11865 SW 26th ST, Unit G-10, Miami, FL 33174 6830 Pines Blvd, Pembroke Pines, FL 33024 1609 E Vine St, Kissimmee, FL 34744 7206 N Armenia Ave, Tampa, FL 33603 7000 SW 62nd Ave, Ste 300, S. Miami, FL 33143 5240 West Flagler St, Miami, FL 33124 700 SW 8 Street, Miami, FL 33130

305-759-4778 305-559-8333 954-987-5010 407-944-1319 813-933-2800

Secretary 1/25/06

Broward Living Water Care Center, North Site 1039 NE 3rd Ave, Ft. Lauderdale, FL 33304 8/18/06 VHCPP Board approved pursuant to 458.317

Broward Living Water Care Center, South Site 3610 SW 48th Ave, Pembroke Pines, FL 33023 8/18/06 VHCPP Board approved pursuant to 458.317

Broward Centro Medico Familiar Buen Pastor, Inc. 4440 Sheridan St, Ste C, Hollywood, FL 33021 8/6/09 Secretary Broward Elite Medical 3429 W Oakland Park Blvd, Lauderdale, FL 33311 5/3/2011 SSG Broward Miguel A. Aponte, MD 7300 West McNab Road, Ste. 113, Tamarac, FL 33321 954-582-1200 9/8/11 SSG Broward L & M Medical Clinic 2100 E. Hallandale Beach Blvd., #202, Hallandale, FL 954-239-0578 01/19/12 SSG


4/07/2015


Method of Approval

33009 Broward Cintex Medical Center and Urgent Care 6245 Miramar Parkway, Ste. 101, Miramar, FL 33023 05/03/12 SSG Broward Broward Outreach Center Hollywood 2056 Scott Street, Hollywood, FL 33022 305-572-2026 05/17/12 SSG Broward Kumar Rajagoplan MD PA 3816 Hollywood Blvd., 102, Hollywood, FL 33021 10/08/12 SSG Broward Zion Clinic Pharmacy 205 E Hallandale Beach Blvd., Hallandale Beach, FL 33009 954-367-5365 10/30/12 SSG Broward Sunset Strip Medical Center 4269 NW 88th Avenue, Sunrise, FL 33351 05/28/13 SSG Broward Emerald Hills Medical Center 3990 Sheridan Street, Ste. 101, Hollywood, FL 33021 05/28/13 SSG Broward Premier Total Healthcare, Inc. 1250 E. Hallandale Beach Blvd, 2nd Floor, Hallandale

Beach, FL 33009 06/28/13 SSG

Broward American Care of South Florida, Inc. 6200 Pembroke Rd., Miramar, FL 33023 1600 W. Oakland Park Avenue, Oakland Park, FL 33311

11/15/1311/15/13

SSG SSG

Broward Harmony Development Center, Inc. 3800 Inverrary Blvd., Ste. 100-C, Lauderhill, FL 33319 05/21/14 SSG Broward Interamerican Medical Center Group, LLC 1225 NW 40th Avenue, Unit 2, Lauderhill, FL 33313 10/11/13 SSG Broward Spectrum Programs, Inc. 226 Southwest 2nd St. Pompano Beach, FL 33060

214 Southwest 2nd St. Pompano Beach, FL 33060 11/19/14 SSG

Broward Reliable Medical Services DBA Centro Medico Samaritano

1597 South State Road 7 North Lauderdale, Florida 33068

1/07/15 SSG

Calhoun Calhoun County Health Department 1507 W. Central Ave, Blountstown, FL 32424-1815 850-674-5645 CHD Charlotte Charlotte County Health Department

514 E. Grace St., Punta Gorda, FL 33950-6198 20101 Peachland Blvd., Pt Charlotte, FL 33954 6868 San Casa Rd., Englewood, FL 34223

941-639-1181 941-255-7424 941-474-3240

N/A CHD

Charlotte St. Vincent de Paul Community Health Clinic 21450 Gibralter Dr, Port Charlotte, FL 33952 (address from Sunbiz: 1282 Market Circle, Unit 6, Port Charlotte, FL 33953)

941-766-3570 12/13/07 VHCPP

Charlotte St. Vincent De Paul Community Health Care, Inc.

21297-B Olean Blvd., Port Charlotte, FL 33952 09/06/13 SSG

Citrus Citrus County Health Department 3700 W. Sovereign Path, Lecanto, FL 34461-8071 352-527-1288 CHD Citrus Nature Coast Ministries 838 N. Citrus Avenue, Crystal River, FL 34429 352-563-1860 06/12/12 SSG Citrus Eihab H.Tawfik, MD, PA DBA Christ Medical

Center 7562 West Gulf to Lake Highway Crystal River, FL 34429 03/31/15 SSG

Clay Clay County Health Department - Bear Run Clinic - Keystone Heights Clinic

1305 Idlewild Ave., Green Cove Sgs, FL 32043 3229 Bear Run Blvd., Orange Park, FL 32073 115 Commercial Dr., Keystone Heights, 32656

904-529-2277 904-272-3177 904-473-4172

CHD VHCPP

Clay Penney Retirement Community P.O. Box 555, Penney Farms, FL 32079 (3495 Hoffman St, Penny Farms, FL 32079)

904-284-8531

Clay The Way Free Medical Clinic, Inc 11 Martin Luther King Jr. Blvd, Green Cove Springs, FL 904-215-0624 VHCPP


4/07/2015


Method of Approval

32079 479 Houston St., Green Cove Springs, FL 32043

10/15/13

SSG

Clay Jacksonville Multispecialty Group, LLC 3052 Highway 17, Green Cove Springs, FL 32043 06/25/14 SSG Collier Collier County Health Department

P.O. Box 429, Naples, FL 33939-0428 419 N. First St., Immokalee, FL 33934

941-774-8210 941-657-2210

2/6/93 CHD

Collier Collier Health Services, Inc. - Central Naples Pediatrics - Creekside Pediatrics - Golden Gate Pediatrics - Mike Davis Medical Center - Immokalee Family Care Center - Marco Island Pediatrics - Marion E. Feather Medical Center

1454 W. Madison Ave., Immokalee, FL 34142 3425 10th Street, N., Naples, FL 34103 1284 Creekside St., #107, Naples, FL 34108 5262 Golden Gate Parkway, Naples, FL 34116 1755 Heritage Trail, Ste. 604, Naples, FL 34112 1502 Lake Trafford Road, Immokalee, FL 34142 40 Heathwood Drive, Marco Island, FL 34145 1454 W. Madison Ave., Immokalee, FL 34142

239-658-3000 239-262-3669 239-591-1755 239-353-4101 239-657-6363 239-394-0693 239-658-3000

12/8/96

9/22/11

s. 330

Collier David Lawrence Cntr and Collier Health Svc., Inc.

6075 Goldengate Parkway, Naples 941-435-0035 VHCPP

Collier Community Medical Care Center, Inc. 214 South 1st Street, Immokalee, FL 34142 03/25/11 SSG Columbia Columbia County Health Department

- Fort White Clinic 249 East Franklin Street, Lake City, FL 32055 Dortch Street, Fort White, FL 32038

386-758-1037 386-497-4899

CHD

Columbia North Central Florida Hospice, Inc./DBA Haven Hospice/Suwannee Valley Care Center

6037 West US Highway 90, Lake City, FL 32055 02/26/14 SSG

Columbia Dynamic Health Centers, Inc. 2806 West US Highway 90, Ste. 102, Lake City, FL 32055 04/23/14 SSG Dade Borinquen Health Care Center 3601 Federal Highway N., Miami, FL 33137 305-576-6611 s. 330 Dade Camillus Health Concern

- Better Way of Greater Miami - Salvation Army

336 NW 5th St., Miami, FL 33101 800 NW 28th Street, Miami, FL 33127 1907 NW 38th Street, Miami, FL 33142

305-577-4840 305-634-4797 305-637-6700

VHCPP s. 330

Dade North Miami Beach Medical Center, Inc. 4450 NW 135th St, Opa-Locka, FL 33054 (786) 888-8800 VHCPP Dade Citrus Health Network (Administration)

- Citrus Health Network Clinic 4125 W. 20th Avenue, Hialeah, FL 33012 4175 W. 20th Avenue, Hialeah, FL 33012

305-825-0300 305-424-3120

s. 330

Dade Community Health of South Florida, Inc. (previously Community Health of South Dade, Inc.) - Women’s Center - Copes South - Doris Ison Health Center - Everglades Health Center

10300 SW 216th St., Miami, FL 33190 820 SW 1st ST, Homestead, FL 33030 10225 SW 147th St, Miami, FL 33176 10300 SW 216th St., Miami, FL 33190 19300 SW 376th St., Florida City, FL 33034

305-253-5100 305-247-3087 305-253-8073 305-253-5100 305-246-4607

12/8/96 s. 330


4/07/2015


Method of Approval

- Martin Luther King Jr. Clinic Campesina - Naranja Health Center - West Perrine Health Center - Marathon Health Center Community Health of South Florida, Inc. School Based Health Locations - HA Ammons Middle School - John Ferguson Senior High School - G. Holmes Braddock Sr High School - West Miami Middle School - Campbell Drive Elementary School - West Homestead Elementary School - Laura Saunders Elementary School - R.R. Morton Elementary School - Dorothy Wallace COPE South - South Wood Middle School - Royal Green Elementary - William S. Chapman Elementary - Dr. Bowman Foster Ashe Elementary - Jane Roberts Elementary - Flagami Elementary School - Campbell Drive Middle School - South Dade Sr. High School - Homestead Senior High School - Colonial Drive Elementary School - Perrine Elementary - Howard D. McMillan Middle School - Redondo Elementary - Leisure City K-8 - Avocado Elementary - Florida City Elementary - Airbase Elementary - Homestead Middle School

810 W. Mowry St., Homestead, FL 33030 13805 SW 264th St., Naranja, FL 33032 18255 Homestead Ave, Perrine, FL 33157 2855 Overseas hwy, Marathon, FL 33050 17990 SW 142nd Ave, Miami, FL 33177 15900 SW 56th St, Miami, FL 33185 3601 SW 147th Ave, Miami, FL 33185 7525 SW 24th St, Miami, FL 33135 15790 SW 307th St, Leisure City, FL 33033 1550 SW 6th St, Homestead, FL 33030 505 SW 8th St, Homestead, FL 33030 18050 Homestead Ave, Perrine, FL 33157 10225 SW 147th Terrace, Miami, FL 33176 16301 SW 80 Ave, Miami, FL 33157 13047 SW 47th St, Miami, FL 33175 27190 SW 140 Ave, Homestead, FL 33032 6601 SW 152nd Ave, Miami, FL 33193 14850 SW Cottonwood Circle, Miami, FL 33185 920 SW 76th Ave, Miami, FL 33144 900 NE 23rd Ave, Homestead, FL 33033 28401 SW 167th Ave, Homestead, FL 33030 2351 SE 12th Ave, Homestead, FL 33034 10755 SW 160 St, Miami, FL 33157 8851 SW 168th St, Perrine, FL 33157 13100 SW 59th St, Miami, FL 33183 18480 SW 304th St, Homestead, FL 33030 14950 SW 288th St, Homestead, FL 33033 16969 SW 294th St, Homestead, FL 33030 364 NW 6th Ave, Florida City, FL 33034 12829 SW 272nd St, Homestead, FL 33032 650 NW 2nd Ave, Homestead, FL 33030

305-248-4334 305-258-6813 305-234-7676 305-743-4000 305-252-2193 305-752-0834 305-552-6205 305-261-9986 305-246-5617 305-245-1368 305-242-0973 305-238-9520 305-233-1044 305-251-5361 305-221-4452 305-245-1331 305-382-8760 305-220-8254 305-261-1184 305-245-8751 305-247-4244 305-242-2244 305-235-7284 305-235-2442 305-385-6877 305-247-5943 305-247-5431 305-247-4942 305-247-4676 305-258-3676 305-247-4221

Dade Dade County Health Department 1350 NW 14th Street, Miami, FL 33125-1696 305-324-2400 CHD


4/07/2015


Method of Approval

Dade Economic Opportunity Family Health Center (now called Jessie Trice Community Health Center, Inc) - Charles R. Drew Elementary - Charles R. Drew Middle School - Cope Center North - EOFHC, Inc./North - Family Health Center at Citrus Health - Hialeah Medical Ctr at Flamingo Plaza - Florida Memorial College - James E. Scott Satellite Center - Women’s Residential Center - Jessie Trice Center for Community Health - Lilly C. Evans Elementary - Poinciana Park Elementary - Brownsville Middle School - Miami Edison Sr/Children’s School Clinic - Miami Edison Middle School - Norland Healthcare Center - OB/GYN Services (Women’s Service Ctr) - Miami Central Cr. High - Broadmoor Elementary - Madison Middle School - Gratigny Elementary School - Miami Park Elementary - Phillis Wheatley Elementary - Toussaint L’Ouverture Elementary - Earlington Heights Elementary - Orchard Villa Elementary - Shadowlawn Elementary - Olinda Park Elementary

700 S. Royal Poinciana Blvd., #300, Miami, FL 33166 1775 NW 60th St., Miami, FL 33147 1801 NW 60th St, Miami, FL 33147 9950 NW 19th Ave., Miami, FL 33147 1220 NW 95th St, Miami, FL 33150 4175 W. 20th Ave., Miami, FL 33012 901 E. 10th Ave., #39, Miami, FL 33010 15800 NW 42nd Ave., Miami, FL 33056 7200 NW 22nd Ave., Miami, FL 33147 2985 NW 54th St., Miami, FL 33142 5361 NW 22nd Ave., Miami, FL 33142 1895 NW 75th St., Miami, FL 33147 6745 NW 23rd Ave., Miami, FL 33147 4899 NW 24th Ave, Miami, FL 33142 6161 NW 5th Ct, Miami, FL 33127 6101 NW 2nd Ave, Miami, FL 33127 18360 NW 7th Ave, Miami, FL 33169 1190 NW 95th St, Ste 110, Miami, FL 33150 1781 NW 95th St, Miami, FL 33147 3401 NW 83rd St, Miami, FL 33147 3400 NW 87th St, Miami, FL 33147 11905 N Miami Ave, Miami, FL 33168 2225 NW 103rd St, Miami, FL 33147 1801 NW 1st Pl, Miami, FL 33136 120 NE 59 St, Maimi, FL 33137 4750 NW 22nd Ave, Miami, FL 33142 5720 NW 13th Ave, Miami, FL 33142 149 NW 49th St, Miami, FL 33142 5536 NW 21st Ave, Miami, FL 33142

305-805-1700 305-694-2362 305-694-2362 305-691-4547 305-694-6900 305-558-0151 305-887-0004 305-626-3760 305-759-3700 305-887-0004 305-835-8122 305-637-6498 305-637-6400 305-694-2366 305-696-1501 305-635-7505 305-754-7044 305-754-3570 305-696-1501 305-696-7759 305-696-4161 305-691-0861 305-696-7759 305-681-6685 305-691-6361 305-573-2638 305-758-2600 305-635-7505 305-696-7759

4/8/94 s. 330

Dade Helen B. Bentley Family Health Center, Inc. 3090 37th Ave., SW, Coconut Grove, FL 33133 305-351-1316 s. 330 Dade Little Havana Activities and Nutrition Center 700 SW 8th Street, Miami, FL 33130-3300 305-858-0887 6/5/92 Dade Miami Dade County Health Department 1350 N.W. 14th St, Miami, FL 33125 305-3242454 CHD Dade Miami Beach Community Health Center

(Stanley C. Myers) - Beverly Press Satellite Center - Dr. Solomon-Lichter Hi-Tides Hlth Ctr

710 Alton Road, Miami, FL 33139 1221 71st St., Miami Beach, FL 33141 2231 Prairie Ave., Miami Beach, FL 33139

305-538-8835 305-538-8835 305-534-4004

12/6/96 s. 330


4/07/2015


Method of Approval

- North Miami Center - Center for Haitian Studies

12340 NE 6th Court, North Miami, FL 33161 8260 NE 2nd Ave, Miami, FL 33138

Dade Project Access 8000 Biscayne Blvd, Miami, FL 33138 11865 SW 26th ST, Unit G-10, Miami, FL 33174 6830 Pines Blvd, Pembroke Pines, FL 33024 1609 E Vine St, Kissimmee, FL 34744 7206 N Armenia Ave, Tampa, FL 33603 7000 SW 62nd Ave, Ste 300, S. Miami, FL 33143 5240 West Flagler St, Miami, FL 33124 700 SW 8 Street, Miami, FL 33130

305-759-4778 305-559-8333 954-987-5010 407-944-1319 813-933-2800

Secretary 1/25/06

Dade Center for Haitian Services, Health & Human Services, Inc.

8260 NE 2nd Ave, Miami, FL 33138 (305) 757-9555 6/3/06 Board approved

Dade Panamerican Health Center, Inc. 4750 NW 7th St, Ste 13, Miami, FL 33126 305-567-0060 8/6/2009 Secretary Dade Latin Foundation for Health, Inc. 8260 W Flagler St, Ste 2-M, Miami, FL 33144

815 NW 57th Avenue, Ste. 144, Miami, FL 33126 305-903-9711 10/30/09

05/28/13SSC SSG

Dade Miami Rescue Mission 2025 NW 1st Ave, Miami, FL 33124 305-571-2273 2/11/2010

VHCPP

Dade Medical Consulting Center 759 NW 22nd Avenue, Miami, FL 33125 305-649-0492 12/7/11 SSG Dade Larkin Community Hospital Clinic,

Comprehensive Medical Access (CMA), Inc

6140 SW 70th St, S. Miami, FL 33143 7031 Southwest 62nd Avenue, South Miami, FL 33143

10/15/1010/15/10

SSG SSG

Dade Anchor Medical Center 12781 Bird Rd, Miami, FL 33175 12781 S.W. Bird Rd., Ste. H, Miami, FL 33175

786-953-8221

12/8/1002/22/13

SSG SSG

Dade St. John Clinic Medical Center 161 NW 29 Street, Miami, FL 33127 12/8/2010

SSG

Dade A&F Medical Services, Inc. 4726 West Flagler St, Miami, FL 33134 3/11/2011

SSG

Dade Primary Wellness Center 6445 SW 8th St, Miami, FL 33144 4/7/2011 SSG Dade J.O. Medical Center, Inc. 42 NW 27th Ave, Ste 303, Miami, FL 33125 4/13/201

1SSG

Dade Paradigm Medical Center 1250 NW 7th St, Ste 101, Miami, FL 33125 4/13/2011

SSG

Dade Clear Image Aesthetic Center, LLC 2601 SW 37th Avenue, Suite 901, Miami, FL 33133 786-953-5355 10/26/11 SSG Dade Group of Miami, LLC 1394 Coral Way, Miami, FL 33145 4/18/201

1SGG

Dade Better Health Systems, Inc 85 Grand Canal Dr, Ste 209, Miami, FL 33144 4/19/2011

SSG

Dade Archy’s Diagnostic Center 35 SW 114th Ave, Ste 201, Miami, FL 33174 5/18/201 SSG


4/07/2015


Method of Approval

1Dade Roig Ortho & Rehab Center 932 SW 82nd Avenue, Miami, FL 33144

938 SW 82nd Avenue, Miami, FL 33144 305-261-9480 305-261-9480

9/19/1106/06/12

SSG SSG

Dade Express Medical Center, Inc. 1250 SW 27th Ave, Ste 301, Miami, FL 33135 5/18/2011

SSG

Dade Care Plus Center, LLC 8260 W Flagler St, Ste 2B, Miami, FL 33144 5/18/2011

SSG

Dade Vega Medical Center 3720 SW 107th Ave, Ste 1, Miami, FL 33165 6/8/2011 SSG Dade Vega Medical Center 3720 SW 107th Ave., Miami, FL 33165 7/13/201

1SSG

Dade Orthopedic Traumatology & Rehab Center 9950 SW 40th Street, Miami, FL 33165 06/08/11 SSG Dade Flare Medical Services 8370 SW Flagler Street, Suite 120, Miami, FL 33144 06/08/11 SSG Dade Sanchez Cazau Medical Group 7171 Coral Way, Suite 200, Miami, FL 33155

344 West 65th Street, Ste. 202, Hialeah, FL 33012 305-889-6670

08/04/1103/06/13

SSG SSG

Dade LMG Medical Center, Inc. 7201 SW 8th Street, Miami, FL 33144 8/16/11 SSG Dade Medical Center of West Miami, Inc. 6469 SW 8th Street, Miami FL 33144 8/16/11 SSG Dade RP Comprehensive Health Care, Inc. 7500 Southwest 8th Street, Ste 301, Miami, FL 33144 8/16/11 SSG Dade All Future Medical Center 3237 NW 7th Street, Ste. 101, Miami, FL 33125

7376 N.W. 35th Terrace, Ste. 104, Miami, FL 33122

8/16/1105/08/13

SSG SSG

Dade Mariano M. Martinez M.D., P.A. 7000 SW 62nd Avenue, Ste 300, Miami, FL 33143 8/16/11 SSG Dade Selem Medical Center 4800 West Flagler Street, Miami, FL 33134 8/16/11 SSG Dade Med-Care Quality Medical Centers, LLC 7200 Northwest 7th Street, Miami, FL 33143 8/30/11 SSG Dade GMC Group of Miami, LLC 2601 Southwest 37th Avenue, Ste. 901, Miami, FL 33133 8/31/11 SSG Dade Romeu Clinical Enterprises 1393 SW 1st Street, Ste. 320, Miami, FL 33135 305-544-0977 9/8/11 SSG Dade ACN Physician Group Corp. 7490 SW 23rd Street, Ste. 201-A, Miami, FL 33155 786-649-0492 11/10/11 SSG Dade ACN Roig’s Orthopaedic Center 7500 SW 8th Street, Ste. 303, Miami, FL 33144 01/05/12 SSG Dade Comfort Health Management 8300 West Flagler Street, Suite 210, Miami, FL 33144 305-553-0270 01/19/12 SSG Dade Dr. Rafael A. Penalver Clinic, Inc. 971 NW 2nd Street, Miami, FL 33128 305-545-7737 01/19/12 SSG Dade RCD Medical Center, Inc. 973 SW 8th Street, Miami, Fl 33130 786-533-1959 03/01/12 SSG Dade Discovery Therapy, Inc. 2141 SW 1st Street, Ste. 206, Miami, FL 33135 305-643-0488 03/01/12 SSG Dade First Choice Pain Management, LLC 4150 NW 7th Street, Ste. 205, Miami, FL 33126 786-536-5185 03/20/12 SSG Dade Nova Health Center, Corp. 8900 SW 24th Street, Ste. 202, Miami, FL 33165 04/03/12 SSG Dade The Wellness Center of Miami Group, Inc. 7640 N.W. 25th Street, Ste. 103, Miami, FL 33122 04/04/12 SSG Dade Universal Professional Care, Inc. 35 SW 114th Avenue, Ste. 105, Miami, FL 33174 305-554-1952 04/20/12 SSG Dade MIA Medical Dental Center Inc. 1394 SW Coral Way (22nd Street) , Miami, FL 33145 305-778-5166 05/11/12 SSG Dade Private Medical Center, Inc. 10 NW 42nd Avenue, Ste. 300, Miami, FL 33126 305-774-0742 05/17/12 SSG


4/07/2015


Method of Approval

Dade Caribe Medical Center of Homestead, Inc. 26799 S. Dixie Highway A, Naranja, FL 33032 305-258-6070 06/12/12 SSG Dade Sunshine Medical Care Group, Inc. 3990 West Flagler Street, Ste. 406, Miami, FL 33134 305-456-3879 06/22/12 SSG Dade Gold Coast Physicians Partners, LLC d/b/a

Penalver Clinic Medical Group 971 NW 2nd Street, Miami, FL 33128 305-545-7737 06/15/12 SSG

Dade March Medical Center LLC 6714 W. Flagler Street, Miami, FL 33144 954-424-1873 07/10/12 SSG Dade Prestige Medical Services 12905 SW 42nd Street, Ste. 101, Miami, FL 33175 305-260-5404 07/27/12 SSG Dade MED-Plan Clinic LLC 7200 Northwest 7th Street, Suite 202, Miami, FL 33126 305-262-1610 08/28/12 SSG Dade Aballi Medical Care, Inc. 5931 SW 8th Street, Miami, FL 33144 305-263-6561 09/06/12 SSG Dade IM Orthopedics & General Medicine Inc. 8150 SW 8th Street, Ste. 205, Miami, FL 33144 786-275-4841 09/13/12 SSG Dade Professional Rehabilitation Service, Inc. 11285 SW 211 Street, Ste. 201, Miami, FL 33189 09/25/12 SSG Dade Health Medical Center of Miami Inc. 868 SW 1st Street, Miami, FL 33130-1208 10/08/12 SSG Dade Policlinico Pastorita Inc 1111 SW 8th Street, Ste. 203, Miami, FL 33130-3639 10/08/12 SSG Dade A & L Clinic Center, Inc. 295 Park Blvd., Miami, FL 33126 305-261-7979 10/30/12 SSG Dade Gables Medical Care, Inc 85 Grand Canal Drive 400, Miami, FL 33144 954-465-7489 10/30/12 SSG Dade Miami Community Health Center 2324 SW 8th Street, Miami, FL 33135 305-487-2720 11/07/12 SSG Dade Comfort Health Group Inc. 5190 NW 167th St., Ste. 109, Miami, FL 33014 305-384-6450 12/10/12 SSG Dade Coral Way Rehab Center 12260 SW 8th St., Ste.232, Miami, FL 33185 305-303-4389 02/22/13 SSG Dade Renato C. Dominguez MD/Dba Real Family

Medical Center 285 NW 27 Ave., Ste. 14, Miami, FL 33125 305-642-4444 02/22/13 SSG

Dade Salud Medical Center, Inc. 1338 SW 8th Street, Miami, FL 33135 305-854-4443 02/22/13 SSG Dade Clinical Research of Miami, Inc. 7200 NW 7th Street, Ste. 206, Miami, FL 33126 305-264-3025 03/06/13 SSG Dade JAGS Medical Office, Inc. 8748 SW 8th Street, Miami, FL 33174 305-220-2338 03/06/13 SSG Dade JO Medical Center, Inc. 2260 SW 8th Street, Ste. 200, Miami, FL 33135 305-642-7704 03/06/13 SSG Dade Megatesting, Inc. 2322 NSW 28th Street, Miami, FL 33142

9600 SW 8th Street, Ste. 30, Miami, FL 33174 305-633-3667

03/06/1304/18/13

SSG SSG

Dade Interamerican Medical Center Group LLC DBA Health First Medical Center

7900 NW 27th Avenue, Ste. D10, Miami, FL 33147 04/03/13 SSG

Dade Interamerican Medical Center Group LLC 11348 Quail Roost Dr., Miami, FL 33157 291 Southwest 27th Avenue, Miami, FL 33135 7101 West Flagler Street, Miami, FL 33144 4155 Southwest 130th Avenue, Ste. 201, Miami, FL 33175

04/03/1304/29/1404/29/1404/29/14

SSG SSG SSG SSG

Dade Lavandera Medical Center 1281 NW 6th Street, Ste., D-2, Miami, FL 33125 04/03/13 SSG Dade San Francis Community Care 14055 West Dixie Highway, North Miami, FL 33161 05/08/13 SSG Dade Med Plus Inc. 3500 NW 17th Avenue, Miami, FL 33142-5540 05/08/13 SSG Dade MedRehab of Florida 8700 West Flagler St., Ste. 260, Miami, FL 33174 07/17/13 SSG Dade Physicians Associates PA 606 W. Flagler St. Miami, FL 33130 07/17/13 SSG


4/07/2015


Method of Approval

Dade New Health Research Clinic 10346 West Flagler St., Miami, FL 33174 07/26/13 SSG Dade Florida Rehabilitation Center, Corp. 815 NW 57th Avenue, Ste. 150, Miami, FL 33126 10/09/13 SSG Dade Coverall Medical Center Corp. 61 Hook Square, Miami Springs, FL 33166 10/15/13 SSG Dade New Life Medical Institute, Inc 861 SW 8th Street, Miami, FL 33130 11/15/13 SSG Dade American Care of South Florida, Inc 11255 SW 211 Street, A, Miami, FL 33189

2315 W. Flagler Street, Miami, FL 33135 1521 NW 54th Street, Miami, FL 33142

11/15/1312/13/1312/13/13

SSG SSG SSG

Dade Miami Rescue Mission Health Clinic 955 N. W. 3rd Street, Ste. 105, Miami, FL 33128 12/09/13 SSG Dade Empower U, Inc. 7900 N. W. 27th Avenue, Ste. E-12, Miami, FL 33147-4909 12/23/13 SSG Dade Doctor’s Care & Research, Inc 9600 SW 8th Street, Ste. 18, Miami, FL 33174 12/20/13 SSG Dade Paradigm Medical Center, LLC 815 NW 57th Avenue, Miami, FL 33126 12/31/13 SSG Dade Ivan Rapado Viera, M.D. 7000 S W 62nd Ave., Ste. 300, South Miami, FL 33143 01/27/14 SSG Dade Orlando E. Leiva, c/o ACN Ceiva Medical

Center Corp. 7500 SW 8th Street, Ste. 303, Miami, FL 33144 01/27/14 SSG

Dade Jorge L. Garcia MD, PA 8300 Southwest 8th Street, Ste. 108, Miami, FL 33144 02/04/14 SSG Dade Advanced Clinical Research of Miami 7815 Southwest 24th Street, Ste. 108, Miami, FL 33155 02/13/14 SSG Dade First Chiropractic Care, Corp. 275 Fontainebleau Blvd. Ste. 245, Miami, FL 33172 02/13/14 SSG Dade Fraga Medical Center, Inc. 11865 Coral Way, Ste. B-7, Maimi, FL 33175 02/26/14 SSG Dade Lazaro Fraga MD, PA 4141 Southwest 6th Street, Miami, FL 33134 02/26/14 SSG Dade Alvarez & Associates Medical Group 3663 Southwest 8th Street, Ste. 214, Miami, FL 33135 03/04/14 SSG Dade Taylor Donovan MD, PA 250 Northwest 183rd Street, Miami Gardens, FL 33169 03/04/14 SSG Dade Discovery Medical Research, Inc. 4872 Northwest 7th Street, Miami, FL 33126 03/04/14 SSG Dade Dade County Jail 13850 NW 41st Street, Miami, FL 33178

1321 NW 13th Street, Miami, FL 33125 6950 NW 41st Street, Miami, FL 33166 7000 NW 41st Street, Miami, FL 33166 1401 NW 7th Avenue, Miami, FL 33136

Pursuant to

Statutes

Pursuant to Statutes

Dade Manuel F. Fernandez, MD, PA 8420 West Flagler Street, Ste. 220, Miami, FL 33144 03/18/14 SSG Dade Premier Medical Center, LLC 6741 Southwest 24th Street, Ste. 38, Miami, FL 33155 08/04/14 SSG DeSoto DeSoto County Health Department 34 South Baldwin Avenue, Arcadia, FL 34266 941-993-4601 CHD DeSoto G. Pierce Wood Memorial Hospital-Arcadia 5847 SE Hwy 31, Arcadia, FL 34266 941-494-3323 Mental

Institution Dixie Dixie County Health Department 1530 SE 12th Ave., Cross City, FL 32628 352-498-1360 CHD Dixie Franklin

North Florida Medical Centers, Inc. – Coop. Office - Family Medical Practice - Eastpoint Medical Center

535 John Knox Road, Tallahassee, FL 32303 351 Horseshoe Bch Rd., Cross City, FL 32628

850-385-4494 352-498-3349 850-670-8585

s. 330


4/07/2015


Method of Approval

Gadsden Lafayette Madison Wakulla Gulf Taylor

- Gadsden Medical & Dental Services - Mayo Health Services - Tri-County Family Health Care - Wakulla Medical Center - Wewahitchka Medical Center - Taylor Dental - Taylor Medical Center - Crestview Health Center

35 Island Drive, # 14, Eastpoint, FL 32328 278 La Salle Lefalle Drive, Quincy, FL 32351 Route 144 SW Virginia Circle, Mayo, FL 32066 193 NW US 221, Greenville, FL 32331 1328 Coastal Highway, Panacea, FL 32346 255 W. River Rd., Wewahitchka, FL 32465 409 E. Ash Street, Perry, FL 32347 1709 S Jefferson St, perry, FL 32348 4100 S Ferdon Blvd, Ste C-5, Crestview, FL 32536

850-875-9500 386-294-1226 850-948-2840 850-984-4735 850-639-5828 850-223-2578

Duval Duval County Health Department - Agape Community Health Center - Beaches Family Health Center - Boulevard Comprehensive Care Center - Center for Prevention Services - Immunization Center - Marietta Family Health Center - Northwest Dental - South Jacksonville Family Health Center - Southside Immunizations - The Bridge - West Jacksonville Family Health Center - Westconnett Family Health Center - Woodland Acres Clinic

515 West Sixth St., Jacksonville, FL 32211 1760 Edgewood Avenue, Jacksonville, FL 32208 1522 Penman Road, Jacksonville Beach, FL 32250 1833 Boulevard, Jacksonville, FL 32206 5917 105th Street, Jacksonville, FL 32244 515 West 6th Street, Jacksonville, FL 32206 8299-10 W. Beaver St., Jacksonville, FL 32220 1830 West 45th St., Jacksonville, FL 32209 1736 University Blvd. South, Jacksonville, FL 32216 PERMANENTLY CLOSED 1824 Pearl Street, Jacksonville, FL 32206 120 King Street, Jacksonville, FL 32204 5917 105th Street, Jacksonville, FL 32244 MEDICAL SERVICES TRANSFERRED TO SOUTH JACKSONVILLE FAMILY HEALTH CENTER.

904-630-3300 904-301-4900 904-270-2555 904-665-3040 904-573-4914 904-665-2666 904-630-3390 904-924-1783 904-727-6540 N/A 904-798-4672 904-665-2785 904-357-5899 N/A

CHD

Duval Duval County/Jacksonville Dept. of Corrections 4/6/97 DOC Duval Duval Pre-Trial Detention Facility 4/6/97 Duval I.M. Sulzbacher Hlth Care for the Homeless 611 E. Adams Street, Jacksonville, FL 32202 904-359-0457 VHCPP Duval Jacksonville Community Health Center 5375 Vernon Road, Jacksonville, FL 32209 904-924-1237 10/1/94 Duval Legacy of Care Health Clinic, Inc 6665 Banbury Rd, Jacksonville, FL 32211 10/15/09 VHCPP Duval St. Vincent’s Mobile Health Outreach Ministry 2591 Oak St, Jacksonville, FL 32204 904-308-7911 10/30/09 SSC Duval Diabetico Internacional 5290 Norwood Avenue, Suite 4, Jacksonville, FL 32208 06/08/11 SSG Duval Jacksonville Pediatric Associates, M.D., P.A. 1951 Boulevard, Jacksonville, FL 32206 08/04/11 SSG Duval Holy Trinity Community Medical Center 4001 Confederate Point Road, Jacksonville, FL 32210 904-860-4124 9/27/11 SSG Duval MCCI Group Holdings, LLC, Gateway Medical

Center 5238-16 Norwood Avenue, Jacksonville, FL 32208 904-861-1222 12/7/11 SSG

Duval Emed Urgent & Primary Care PA 2570 Atlantic Blvd., Jacksonville, FL 32207 904-647-8576 06/15/12 SSG Duval Volunteers in Medicine-Jacksonville 41 East Duval Street, Jacksonville, FL 32202 904-399-2766

x123 04/18/13 SSG


4/07/2015


Method of Approval

Duval Jacksonville Multispecialty Group, LLC 3720 Beach Blvd., Jacksonville, FL 32207 06/28/13 SSG Duval American Care of North Florida, Inc. 1918 Blanding Blvd, Jacksonville, FL 32210 12/03/13 SSG Escambia Escambia County Health Department

- Century Health Department - Molino Health Department - WIC Westside

1295 W. Fairfield Dr., Pensacola, FL 32501 501 Church St., Century, FL 32535 3470 Hwy 29 N, Molino, FL 32533 120 Chief’s Way, Pensacola, FL 32507

850-595-6500 850-256-6203 850-587-3129 850-453-7588

CHD

Escambia Our Lady of Angels Clinic (St. Joseph Medical Clinic)

140 W. Government St., Pensacola, FL 32501 850-436-6461 2/6/04 VHCPP

Escambia Health & Hope Clinic 9999 Chemstrand Rd, Pensacola, FL 32514 850-479-4456 2/09 VHCPP Escambia Health & Hope Clinic 501 Church Street, Century, FL 32535 850-471-3430 03/22/12 SSG Escambia Pensacola Medical Clinic, LLC 2407 W. Cervantes Street, Pensacola, FL 32505 12/20/13 SSG Escambia Escambia County Jail 2935 N. L Street, Pensacola, FL 32501 08/27/14 SSG Flagler Flagler County Health Department 301 South Lemon Street, Bunnell, FL 32110 904-437-7350 CHD Flagler Medical Specialists of Northeast Florida, PLLC 260 Dr. Carter Blvd, Bunnell, FL 32110 4/18/201

1 SSG

Flagler Pediatrics in North Florida, P.A. 385 Palm Coast Parkway SW, Ste. 5, Palm Coast , FL 32137

386-446-8333 03/01/12 SSG

Flagler Bushnell Medical Clinic 117 W. Belt Avenue, Ste. A, Bushnell, FL 33513 10/08/12 SSG Franklin Franklin County Health Department

- Franklin County Health Department 137 12th Street, Apalachicola, FL 32320 106 NE 5th Street, Carrabelle, FL 32322

850-653-2111 850-697-4121

CHD

Franklin Primary Care 4 All 1001 Gray Avenue, Carrabelle, FL 32322 713-828-3973 10/20/11 SSG Gadsden Florida State Hospital-Chattahoochee P.O. Box 1000, Chattahoochee, FL 32324 850-663-7001 Mental

Institution Gadsden Gadsden County Health Department

- Gadsden County Health Department - Gadsden County Health Department

Dr. LaSalle LaFalle Dr., Quincy, FL 32353 604 E. 5th Avenue, Havana, FL 32333 680 Maple Street, Chattahoochee, FL 32324

850-875-7200 850-539-6516 850-663-2241

CHD

Gadsden Gadsden Correctional Facility 6044 Greensboro Highway, Quincy, FL 32351 850-875-9701 x2230

03/15/12 SSG

Gadsden Gadsden Family Clinic 105 E. Jefferson Street, Quincy, FL 32351 850-566-9014 09/06/12 SSG Gadsden Gadsden County Medical & Mental Health

Outpatient Services, LLC 324 Mine Road, Midway, FL 32343 05/28/13 SSG

Gadsden Gadsden County Medical Clinic 809 East Jefferson Street, Quincy, FL 32351 03/17/14 SSG Gilchrist Gilchrist County Health Department 119 NE 1st St., Trenton, FL 32693 352-463-3120 CHD Gilchrist Trenton Medical Center, Inc.

- Kid Care Pediatrics 911 S. Main Street, Trenton, FL 32693 319 W. Wade Street, Trenton, FL 32693

352-463-2374 352-463-6292

s. 330

Glades Glades County Health Department Bldg 998, Hwy 27 N., Moore Haven, FL 33471 863-946-0707 CHD Gulf Gulf County Health Department 502 4th Street, Port St. Joe, FL 32456 850-227-1276 CHD


4/07/2015


Method of Approval

- Gulf County Health Department 232 E. Lake Avenue, Wewahitchka, FL 32465 850-639-2644 Hamilton Hamilton County Health Department 209 SE Central Avenue, Jasper, FL 32052 904-792-1414 CHD Hardee Hardee County Health Department 115 K.D. Revell Road, Wauchula, FL 33873 941-773-4161 CHD

Hardee Sonni’s Pediatrics, Inc. 1125 South 6th Avenue Wauchula, Florida 33873 12/19/14 SSG

Hendry Martin Okeechobee St. Lucie

Florida Community Health Centers, Inc. - Clewiston Center - Ft. Pierce Center - Indiantown Center - Lakeshore Medical - Lakeshore Pediatrics & Dental - Lakeshore Pediatrics Annex - St. Lucie Women & Children - Port St. Lucie Children’s Health Ctr - Pahokee Center

4450 S. Tiffany Drive, W. Palm Bch, FL 33407 315 S. WC Owen Ave., Clewiston, FL 33440 1505 Delaware Ave., Ft. Pierce, FL 34950 15858 SW Warfield Blvd., Indiantown, FL 34956 308 NW 5th Ave, Okeechobee, FL 34972 1100 N Parrott Ave, Okeechobee, FL 34972 103 NE 19th Dr, Okeechobee, FL 34972 1871 SE Tiffany Ave, Ste 200, Port St. Lucie, FL 34952 1701 SE Hillmoor Dr, Ste 19, Port St. Lucie, FL 34952 170 S Barfield Hwy, Ste 103, Pahokee, FL 33476

561-844-9443 863-983-7813 772-461-1402 772-597-3596 863-763-7481 863-763-1951 863-467-6120 772-337-4000 772-335-8455 561-924-6100

s. 330

Hendry Hendry-Glades Mental Health Clinic, Inc. 80 Euclid Place, LaBelle, FL 33975 601 W. Alverdez Ave, Clewiston, FL 33975

863-674-4050 863-983-1423

8/03 8/03

Secretary

Hendry Hendry County Health Department - Hendry County Health Department

P.O. Box 70, 325 Pratt Blvd., Labelle, FL 33935 1100 South Olympia, Clewiston, FL 33440

863-674-4041 863-983-1408

CHD

Hendry Gulf Coast Healthcare Systems, Inc./d.b.a Urgent and Convenient Care Center

700 South Main Street, Ste. A, LaBelle, FL 33935 03/04/14 SSG

Hernando Hernando County Health Department 300 S. Main St., Brooksville, FL 34601 352-754-4067 CHD Hernando Hernando Doctor’s Clinic 12395 Cortez Blvd, Brooksville, FL 34613 352-596-8599 Hernando Pasco

The Harbor Behavioral Health Care Institute, Inc. (formerly Professional Therapy Center , formerly Hernando Co. Mental Health Center) - Harbor Behavioral Health Care Institute - Harbor Behavioral Health Care Institute - Harbor Behavioral Health Care Institute - Harbor Behavioral Health Care Institute

P.O. Box 428, New Port Richey, FL 34646-0428 7809 Massachusetts Ave, New Port Richey, FL 34653 8002 King Helie Blvd, New Port Richey, FL 34643 14527 7th St, Dade City, FL 33523 7074 Grove Rd, Brooksville, FL 34609

727-841-4200 727-841-4200 727-841-4430 352-521-1474 352-540-9335

11/0411/0411/0411/04

Secretary

Hernando Ridge Manor Medical Clinic 34498 Cortez Blvd., Ridge Manor, FL 33523 10/08/12 SSG Highlands Polk Hardee

Central Florida Health Care, Inc. - Central FL Health Care - Dundee - Central FL Health Care - Frostproof - Central FL Health Care – Wauchula

950 CR 17A, West, Avon Park, FL 33825 916 State Road 542, Dundee, FL 33838 109 W. Wall St., Frostproof, FL 33843 204 E. Palmetto St., Wauchula, FL 33873

863-452-3000 863-419-3330 863-635-4891 863-773-2111

s. 330


4/07/2015


Method of Approval

- Lakeland OB/GYN - Lakeland Primary Care

1729 Lakeland Hills Blvd, Lakeland, FL 33805 936 E Parker St, Lakeland, FL 33801

863-686-0082 863-413-8600

Highlands Highlands County Health Department - Avon Park Clinic - Lake Placid Clinic

7205 S. George Blvd., Sebring, FL 33875-5847 400 S Lake Ave, Avon Park, FL 33825 107 N. Main St., Lake Placid, FL 33852

863-386-6040 863-452-6411 863-465-2252

CHD

Highlands Providence Community Health Center, Inc 4141 US HWY N, Ste 7, Sebring, FL 33870 954-461-5981 305-609-9211

6/23/09 Secretary

Highlands Sebring Pediatrics, LLC 3201 Medical Way, Suite 101 Sebring, Florida 33870 2/24/15 SSG Highlands Heartland Pediatrics of Lake Placid, Inc. 344 East Royal Palm Street, Suite #3 Lake Placid, FL

33852 2/26/15 SSG

Highlands Avon Park Pediatrics, Inc. 1571 US Highway 27 North Avon Park, Florida 33825 02/26/15 SSG Hillsborough Hillsborough County Health Department

- Joyce Ely Health Center - Kelton Health Center - North Hillsborough Health Center - Plant City Health Center - Sulphur Springs Health Center West Tampa Health Center

1105 E. Kennedy Blvd, Tampa, FL 33602-3591 205 14th Ave. S.E., Ruskin, FL 33570 4420 Montgomery Ave., Tampa, FL 33616 9827 N. Sheldon Road, Tampa, FL 33615 302 N. Michigan Ave., Plant City, FL 33566 8605 N. Mitchell, Tampa, FL 33604 2103 N. Rome Ave., Tampa FL 33607

813-307-8008 813-671-7755 813-307-8055 813-307-8053 813-307-8057 813-307-8054 813-307-8058

CHD

Hillsborough Center for Family Health (previously ELDERMED)

912 E. Sligh Ave, Tampa, FL 33674-9384 813-237-6988 12/6/92 VHCPP

Hillsborough Project Access 8000 Biscayne Blvd, Miami, FL 33138 11865 SW 26th ST, Unit G-10, Miami, FL 33174 6830 Pines Blvd, Pembroke Pines, FL 33024 1609 E Vine St, Kissimmee, FL 34744 7206 N Armenia Ave, Tampa, FL 33603 7000 SW 62nd Ave, Ste 300, S. Miami, FL 33143 5240 West Flagler St, Miami, FL 33124 700 SW 8 Street, Miami, FL 33130

305-759-4778 305-559-8333 954-987-5010 407-944-1319 813-933-2800

Secretary 1/25/06

Hillsborough Suncoast Community Health Centers, Inc. - Dover Health Center - Plant City Family Care - Ruskin Health Center

P.O. Box 1349, Ruskin, FL 33570 14618 SR 574, Dover, FL 33527 508 N. Maryland Ave., Plant City, FL 33566 2814 14th Ave, SE, Ruskin, FL 33570

813-349-7568 813-349-7700 813-349-7600

s. 330

Hillsborough Tampa Community Health Centers, Inc. - Central Park Health Center - Lee Davis Health Center - North Tampa Community Health Center - Oak Park Health Center - Peter Davis Health Center

1229 E. 131st Avenue, Tampa, FL 33612 1001 India Street, Tampa, FL 33602 3402 N. 22nd Street, Tampa, FL 33605 1229 E. 131 Avenue, Tampa, FL 33612 4916 E. 10th Avenue, Tampa, FL 33605 1401 E. 22nd Avenue, Tampa, FL 33605

813-866-0930 813-229-3585 813-227-6240 813-866-0950 813-248-1151 813-248-6263

s. 330


4/07/2015


Method of Approval

- Sine Domus Health Center 1549 Franklin Street, Tampa, FL 33602 813-277-9227 Hillsborough West Tampa Medical Clinic, Inc 2309 W Martin Luther King, Jr, Blvd, Unit 5, Tampa, FL

33607 1/5/2010 SSG

Hillsborough Tampa Family Physicians, Inc. 4603 N Armenia Ave, Tampa, FL 33603 6/8/2010 SSG Hillsborough Orlando Rangel, MD, PA 4060 Armenia Ave, Tampa, FL 33607 11/4/201

0SSG

Hillsborough Kenaday Medical Clinic 8001 N Dale Mabry Hwy, Bldg. 701-801, Tampa, FL 33614

12/13/2010

SSG

Hillsborough Horizon Medical Center 3956 W Hillsborough Ave, Tampa, FL 33614 1/10/2011

SSG

Hillsborough Raul Ayala, M.D., PA 10508 Gibsonton Dr, Riverview, FL 33578 2/11/2011

SSG

Hillsborough Raul Ayala Internal Medicine 10431 S County Rd 39, Lithia, FL 33547 2/11/2011

SSG

Hillsborough Doctors N Us Walk-In Clinic 6821 W Hillsborough Ave, Tampa, FL 33634 5/16/2011

SSG

Hillsborough Medical Arts Center 4600 North Habana Avenue, Tampa, FL 33614 8/16/11 SSG Hillsborough Pain and Wellness Institute, P.A. 4509 North Armenia Avenue, Tampa, FL 33603 8/16/11 SSG Hillsborough B& T Medical Center, LLC 5301 North Habana Ave., Ste. 1, Tampa, FL 33614 407-944-9191 11/10/11 SSG Hillsborough Florida Care Centers 7208 Sterling Avenue, Tampa, FL 33614 305-384-7277 11/18/11 SSG Hillsborough Florida Care Centers 8488 West Hillsborough Avenue, Tampa, FL 33615 813-889-9800 2/3/12 SSG Hillsborough Foundation Consultant Services, Inc.

DBA Foundational Health 5535 Memorial Highway, Tampa, FL 33634 813-574-4869 11/28/11 SSG

Hillsborough Your Place Health Systems, LLC dba/Your Place Medical & Fitness Center

1793 West Hillsborough Avenue, Tampa, FL 33603 813-579-4013 01/19/12 SSG

Hillsborough Synergy Health Centers, Inc. 318 E. Martin Luther King Blvd., Tampa, FL 33603 813-238-4918 03/05/12 SSG Hillsborough Tampa Family 4618 N. Armenia, Tampa, FL 33603 813-312-9583 04/20/12 SSG Hillsborough Physicians Care Centers of Tampa Bay, LLC

Formally-Dr. Vincent Farrier 2123 W. Dr. Martin Luther King Jr. Blvd., Ste. 101, Tampa, Fl 33607

11/20/13 SSG

Hillsborough Foundational Consultant Services, Inc. DBA Foundational Health

3031 W. Cypress Street, Ste. A, Tampa, FL 33607 813-527-0445 10/30/12 SSG

Hillsborough Douglas G. Stein, MD, PA 3000 East Fletcher Avenue, Tampa, FL 33613 813-972-1365 12/10/12 SSG Hillsborough Jay Care Medical Center 1509 West Reynolds Street, Plant City, FL 33563

5015 E. Busch Blvd. , Tampa, FL 33617 09/25/13

10/15/13SSG SSG

Hillsborough American Care of Tampa, Inc. 8726 West Waters Avenue, Tampa, FL 33615 11211 N. Nebraska Avenue, Tampa, FL 33612

11/04/1312/12/13

SSG SSG

Hillsborough Clear Scope Healthcare, LLC 1201 N. Clearview Avenue, Tampa, FL 33607 11/15/13 SSG


4/07/2015


Method of Approval

Hillsborough Kennedy Walk in Clinic 3308 W. Kennedy Blvd., Tampa, FL 33609 12/13/13 SSG Hillsborough Holistic Medical Care Clinic, LLC 400 Frandorson Circle, Ste. 103, Apollo Beach, FL 33572 12/19/13 SSG Hillsborough Amerimed Diagnostic Services, Inc. 500 West Dr. Martin Luther King Jr. Blvd., Tampa, FL

33603 01/30/14 SSG

Hillsborough Express Care of Tampa Bay, Inc. 11752 East Martin Luther King Blvd., Seffner, FL 33584 6015 Rex Hall Lane, Apollo Beach, FL 33572

03/25/1408/04/14

SSG SSG

Hillsborough Causeway Medical Clinic MedCentral Corp. 7108 Causeway Blvd., Tampa, FL 33619 04/15/14 SSG Hillsborough Florida Family Primary Care Centers of Tampa,

LLC 6726 Hanley Road, Tampa, FL 33634 05/14/14 SSG

Hillsborough MPN Medical Center Plant City, LLC 1501 West Reynolds Street, Ste. 100, Plant City, FL 33566 07/22/14 SSG Hillsborough Agnes Ubani, MD/DBA Windsor Medical Clinic 3558 North 29th Street, Tampa, FL 33605 08/04/14 SSG Hillsborough Jose R. Mole, MD, PA 7001 North Dale Mabry Highway, Ste. B Tampa, FL 33614 10/21/14 SSG Hillsborough Comprehensive Medical Access, Inc.

DBA Centros Medicos Las Americas 7206 North Armenia Avenue Tampa, Florida 33603 12/1/14 SSG

Hillsborough M&M Medical Clinic, LLC 2802 West Waters Avenue Tampa, Florida 33614 12/19/14 SSG Hillsborough

Shiloh Health Centers, LLC 8900 Armenia Avenue North, Suite 206 Tampa, FL 33604 12/19/14 SSG

Hillsborough CAC-Florida Medical Centers, LLC 8326 North Florida Avenue Tampa, Florida 33604 4340 West Hillsborough Avenue Tampa, Florida 33614

1/27/15 SSG

Hillsborough Ideal Medical Center, Inc. 6821 West Hillsborough Avenue Tampa, Florida 33634 2/12/15 SSG Hillsborough Juan C. Bayolo, MD, PA 3430 West Lambright Street, Unit 101 Tampa, Florida

33614 02/26/15 SSG

Hillsborough Iditalya 10 Medical Center 4600 North Habana Avenue, Suite 20 Tampa, Florida 33614

03/19/15 SSG

Holmes Holmes County Health Department P O Box 337, Bonifay, FL 32425-0337 850-547-3691 CHD Holmes Community Health Center – Bruce 278 Church Road, Bruce, FL 32455 850-835-1015 10/24/12 SSG Indian River Treasure Coast Community Health Center 12196 CR 512, Fellsmere, FL 32948 772-571-8828 s. 330 Indian River Indian River County Health Department

- Gifford Health Center 1900 27th St., Vero Beach, FL 32960 4690 28th Court, Gifford, FL 32967

561-794-7400 561-770-5151

CHD

Indian River Dick Parvus, M.D., P.A. 32-B North Broadway Street, Fellsmere, FL 32948 06/22/11 SSG Jackson Jackson County Health Department P O Box 310, Marianna, FL 32447-0310 850-482-9862 CHD Jackson Marianna Family Care Center, LLC 2928 Daniels Street, Marianna, FL 32446 850-215-9558 11/28/11 SSG Jefferson Jefferson County Health Department 1255 W. Washington St., Monticello, FL 32344 850-342-0170 CHD Lafayette Lafayette County Health Department Route 3, Box 8, Highway 27, Mayo, FL 32066

140 SW Virginia Circle, Mayo, FL 32066 904-787-8489 386-294-1321 01/22/14

CHD SSG

Lake Community Medical Care Center of Leesburg 1210 W Main St, Leesburg, FL 34748 352-314-8686 2/4/00 VHCPP


4/07/2015


Method of Approval

Lake Florida Hospital Waterman, Inc. – Community Primary Health Clinic

2300 Kurt Street, Eustis, FL 32726 352-589-2501 11/3/04 VHCPP

Lake Lake County Health Department - Lake County Health Department - Lake County Health Department

249 East Collins Street, Umatilla, FL 32784 16140 US Hwy 441, Eustis, FL 32726 9836 US Hwy 441, Leesburg, FL 34788 14 Eustis St, Eustis, FL 32726

352-669-2164

CHD

Lake South Lake Hospital, Inc: South Lake Health Clinic

835 7th St, Bldg B, Ste 5, Clermont, FL 34711 352-243-6280 4/8/06 VHCPP

Lake Kidsville Pediatrics III 1804 Oakley Seaver Dr, Clermont, FL 34711 10/26/2010

SSG

Lake Silverlake Pediatrics, PA 33017 Professional Dr, Leesburg, FL 34788 1/20/211 SSG Lake Shatineketan 999 David Walker Drive, Tavares, FL 32778 06/22/11 SSC Lake Clermont Medical Center, P.A. 1135 Lake Avenue, Clermont, FL 34711 04/03/12 SSG Lake Permier Medical Associates 1004 N 14th St., Ste. 109, Leesburg, FL 34748 352-25-2159 02/22/13 SSG Lake Institute of Cardiovascular Excellence, P.L.L.C. 733 US Highway 466, Lady Lake, FL 32159-6340 04/03/13 SSG Lake Clark Clinic, Inc. 107 W. Central Avenue, Howey-in-the-Hills, FL 34737 07/17/13 SSG Lake Florida Family Physicians 255 Citrus Tower Blvd., Ste. 206, Clermont, FL 34711 08/20/13 SSG Lake Florida Medical Associates, LLC 13940 US Highway 441, Ste. 102, Lady Lake, FL 32159 08/20/13 SSG Lake Louis J. Radnothy, DO, PA 390 South Central Avenue, Umatilla, FL 32784 03/25/14 SSG Lake A Plus Pediatrics, PLLC 706 East Grand Highway, Clermont, FL 34711 04/15/14 SSG Lake Suncoast Premier Medical, LLC 1239 US Hwy 27, Four Corners Area, Clermont, FL 34714 04/23/14 SSG Lake LifeStream Behavioral Center

201 East Magnolia Avenue, Eustis, FL 32726 2140 Don Wickham Dr., Clermont, FL 34711

09/25/1410/01/14

SSG SSG

Lake LifeStream – Lop 215 North 3rd Street, Leesburg, FL 34748 09/25/14 SSG Lake Mid-Florida Primary Care, PA 401 North Blvd West Leesburg, Florida 34748 03/19/15 SSG Lee Hendry Charlotte

Family Health Centers of SW Florida - Cape Coral Medical Office - Broadway Family Practice - Cape Coral Medical Office - Downtown Ft. Myers Center - Paul Laurence Dunbar Medical Office - - Labelle Medical Office - Lehigh Acres Medical Office - Pine Island Medical Office - South Ft Myers Medical Office

2256 Heitman Street, Ft. Myers, FL 33901 305 SW 2nd Terrace, Cape Coral, FL 33990 3594 Broadway Ave, Ft. Myers, FL 33901 305 SW 2nd Terrace, Cape Coral, FL 33900 2232 Grand Ave, Ft. Myers, FL 33901 3511 Dr. Martin Luther King, Jr. Blvd, Ft. Myers, FL 33916930 S Main St, Labelle, FL 33935 391 Lee Blvd, Unit 200, Lehigh Acres, FL 33936 Aqualand Office Pk, 8359 Stringfellow Rd, St. James City, FL 33956 9800 S Healthpark Dr, Ste 110, Ft. Myers, FL 33908

239-278-3600 239-344-2320 239-344-2330 239-344-2320 239-332-0417 239-332-0954 239-332-0417 239-344-2305 239-344-2393

s. 330


4/07/2015


Method of Approval

- Salvation Army/Healthcare for the Homeless 2400 Edison Ave, Ft. Myers, FL 33901 239-267-6219

VHCPP

Lee Lee County Health Department - Lee County Health Department - Lee County Health Department

3920 Michigan Avenue, Ft. Myers, FL 33916 83 Pondella Rd., North Ft. Myers, FL 33903 391 Lee Blvd., Ste 100, Lehigh Acres, FL 33936

941-332-9501 941-332-9501 941-369-4020

CHD

Lee Lee Mental Health Center/dba Ruth Cooper 2789 Ortiz Ave., Ft. Myers, FL 33905 941-275-3222 Lee Bonita Springs Lions Club Clinic 10322 Pennsylvania Ave, Bonita Springs, FL 34135 VHCPP Lee G & C Medical Center, Inc. 4048 Evans Avenue, Ste. 208, Ft. Myers, FL 33901 239-931-4640 03/01/12 SSG Lee Gulf Coast Healthcare Systems, Inc./d.b.a

Urgent and Convenient Care Center 2718 Lee Blvd., Ste. B, Lehigh Acres, FL 33971 03/07/14

0SSG

Lee The Medical Centre of Lehigh Acres, Inc 1303 Homestead Road N Ste., 102 Lehigh Acres, FL 33936 2/24/15 SSG Leon Bond Community Health Center, Inc. 710 W. Orange Avenue, Tallahassee, FL 32310 850-576-4073 s. 330 Leon Florida Department of Corrections 2601 Blairstone Road, Tallahassee, FL 32399-2500 850-410-4567 Leon Leon County Health Department

- Roberts/Stevens Clinic - Southside Clinic

2965 Municipal Way, Tallahassee, FL 32304 1515 Old Bainbridge Rd. Tallahassee, FL 32303 872 Orange Ave. Tallahassee, FL 32301

850-487-3186 850-488-2223 850-414-7845

CHD

Leon Neighborhood Health Services, Inc. 438 W. Brevard Street, Tallahassee, FL 32399 850-224-2469 10/4/96 Physicians under VHCPP

Leon Apalachee Center, Inc. 2634-J Capital Circle NE, Tallahassee, FL 32308 04/03/12 SSG Leon American Care of North Florida, Inc. 1707 South Gadsden, Tallahassee, FL 32301 12/03/14 SSG Levy Levy County Health Department 66 W. Main Street, Bronson, FL 32621 352-486-5305 CHD Levy Regional General Hospital 125 SW 7th St, Williston, FL 32696 12/8/201

0SSG

Levy Institute of Cardiovascular Excellence, P.L.L.C. 412 West Noble Avenue, Williston, FL 32696-2072 352-433-9302 11/07/12 SSG Levy North Central Florida Hospice, Inc/DBA Haven

Hopsice/Tri-Counties Hospice Care Center 311 Northeast 9th Street, Chiefland, FL 32626 02/13/14 SSG

Liberty Liberty County Health Department 247 N. Central St., Bristol, FL 32321 850-643-2415 CHD Madison Madison County Public Health Unit 801 SW Smith Street, Madison, FL 32340 850-973-5000 CHD Manatee Community Coalition on Homeless 701 17th Ave W, Bradenton, FL 34205 941-747-1509 6/6/09 VHCPP

Manatee Desoto Hardee Sarasota

Manatee County Rural Services, Inc. - AIDS Council of Manatee - Arcadia Family Healthcare Center - Community Care Family Clinic - East Manatee Health and Wellness Center - Just for Her - Lawton Chiles Children & Family Health

P.O. Box 106, Parrish, FL 34219 2703 19th St. Ct. E., #2, Bradenton, FL 34208 1707 East Oak Street, Arcadia, FL 34266 1110 East Gibson St., Arcadia, FL 34266 1312 Manatee Ave., East, Bradenton, FL 34208 417 Carlton Street, Wauchula, FL 33873 1515 26th Ave., East, Bradenton, FL 34208

941-776-4000 941-744-9204 863-491-5345 863-494-6222 941-708-8706 863-773-0336 941-708-8600

10/1/94 s. 330


4/07/2015


Method of Approval

Care Center - Manatee Pediatrics & Westgate OBGYN - Michael C. Bach Treatment Center - - North Manatee Health Center - Palmetto Family Healthcare Center - Parrish Health Center - Southeast Family Health Care Center

712 39th Street West, Bradenton, FL 34205 2703 19th St. Ct. E., Bradenton, FL 34208 5600 Bayshore Rd., Palmetto, FL 34221 404 7th Street West, Palmetto, FL 34221 12214 US Hwy 301 North, Parrish, FL 34219 919 53rd Ave. E., Bradenton, FL 34203

941-748-4602 941-708-8500 941-721-2020 941-729-3856 941-776-4000 941-751-8100

Manatee Manatee County Health Department 410 Sixth Ave. East, Bradenton, FL 34208-1986 941-748-0747 CHD Manatee Manatee Glens 391 6th Ave W, Bradenton, FL 34205) P.O. Box 9478,

Bradenton, FL 34206-9478 941-782-4299 10/1/94

Manatee We Care Manatee, Inc. 4808 26thStreet West, Bradenton, FL 34207 941-755-3952 VHCPP Manatee Manatee Memorial Hospital 206 Second Street East Avenue, Bradenton, FL 34208 941-746-5111 04/20/12 SSG Manatee Jaime F. Rubio, MD, Clinica Dr. Rubio 2114 Manatee Avenue E., Bradenton, FL 34208 941-776-3967 04/18/13 SSG Marion Marion County Health Department

- Marion County Health Department - Marion County Health Department - Marion County Health Department

1801 S.E. 32nd Ave., Ocala, FL 34478 7055 S.E. 110th St. Rd., Belleview, FL 34420 20491 The Granda, #5, Dunnellon, FL 34431 4500 N.W. 152nd Lane, Reddick, FL 32686

352-629-0137 352-245-7520 352-489-3828 352-591-2470

CHD

Marion Project Health, Inc. 9305 SE Maricamp Rd, Ocala, FL 34472 11/10/2010

SSG

Marion Heart of Florida Health Center 1025 SW 1st Avenue, Ocala, FL 34471 8/16/11 SSG Marion LaFamilia Medical Clinic, LLC 7625 SW 62nd Court, Ste. 100, Ocala, FL 34476 352-237-8903 03/06/13 SSG Marion Children’s Medical Group 1749 SE 28th Loop, Ocala, FL 34471 05/08/13 SSG Marion Institute of Cardiovascular Excellence, PLLC 10435 SE 170th Place, Summerfield, FL 34491

4730 SW 49th Road, Ocala, FL 34474 3515 SE 17th Street, Ste. 100, Ocala, FL 34471 10982 Southwest 184th St. Miami, Florida 33158

05/28/1307/17/1301/21/14

1/07/15

SSG SSG SSG SSG

Marion Community Family Health Care 11392 East Highway 316, Ft. McCoy, FL 32134-8114 07/26/13 SSG Marion Florida Medical Associates, LLC 6600 SW Highway 200, Ste. 200, Ocala, FL 34476

2955 SE 3rd Court, Ocala, FL 34471 08/20/13

08/20/13SSG SSG

Marion Prompt Primary Care of Ocala Fomally- Institute of Cardiovascular Excellence, PLLC

8750 SW Highway 200, Ste. 102, Ocala, FL 34481 11/19/13 SSG

Marion Cala Hills Medical Center, Inc. 2131 Southwest 22nd Place, Ste. 100, Ocala, FL 34471 04/02/14 SSG Marion Weirsdale Family Health Center, Inc. 16400 South Highway 25, Weirsdale, FL 32195 05/12/14 SSG Marion Marion Heart Center, PA 10230 Southwest 86th Circle, Ocala, FL 34481 06/04/14 SSG Marion American Family Medical, LLC 1750 Southeast 28th Loop, Ocala, FL 34471 08/12/14 SSG Marion Urban Cardiology, LLC 4600 Southwest 46th Court, Bldg.220,Ste.250 Ocala, FL 34474

1800 Southeast 17th Street, Ste. 700, Ocala, FL 34471 09/16/14 SSG


4/07/2015


Method of Approval

2105 Southwest 20th Place, Ocala, FL 33471 09/16/1409/16/14

SSG SSG

Marion Gynecology Specialist of Ocala, PLLC Surgical Consultants of Central Fl. PA

1830 Southeast 18th Avenue, Ste.1, Ocala Fl. 34471 1830 Southeast 18th Avenue, Ste.3, Ocala Fl. 34471

10/8/1410/8/14

SSG SSG

Marion Family Care Affiliates of Ocala, LLC 1830 Southeast 18th Ave., Suite 3, Ocala, FL 34471 10/21/14 SSG Marion Endeavor Physical Therapy Inc. DBA Geril

Therapy 4901 East Silver Springs Boulevard, #305 Ocala, FL 34470 11/03/14 SSG

Marion Marion Heart Center, PA 1040 Southwest 2nd Avenue Ocala, Florida 34471 1/27/15 SSG Marion West Marion Family Practice, PA 8599 Southwest Highway 200 Ocala, Florida 34481 02/26/15 SSG Martin Martin County Health Department

- Martin County Hlth Dept, Indiantown 3441 SE Willoughby Blvd. Stuart, FL 34994 12/17/14 SSG

Martin Volunteers in Medicine Clinic 417 Balboa Ave., Stuart, FL 34994 772-463-4130 4/7/95 VHCPP Miami-Dade Good News Care Center 101 S Redland Rd, Florida City, FL 33034 5/16/201

1SSG

Miami-Dade Regenerate Primary Medical, LLC 6161 Southwest 72nd Street, Ste. B, South Miami, FL 8/30/11 SSG Miami-Dade The Wellness Center of NMB, LLC 1899 NE 164th Street, North Miami Beach, FL 33162 786-274-1990 03/01/12 SSG Miami-Dade Josefa L. Binker, M.D., P.A. 70 N.W. 8th Street, Homestead, FL 33030 305-242-5225 09/04/12 SSG Miami-Dade Urban Mercy Clinics of Miami, Inc. 13899 Biscayne Blvd., Ste. 132, N. Miami Beach, Fl 33181 305-681-1050 12/10/12 SSG Miami-Dade New Life Polyclinics Inc. 61 Hook Square, Miami Springs, FL 33166 305-884-8880 12/10/12 SSG Miami-Dade RiverSide Wellness Center 7911 NW 72nd Avenue #114, Medley, FL 33166 305-525-7956 12/10/12 SSG Miami-Dade Interamerican Medical Center Group LLC 1437 NE 8th Street, Homestead, FL 33033 04/03/13 SSG Miami-Dade Work Injury Solutions of Dade County, Inc

D/B/A Health Care Center of Miami 7911 NW 72nd Avenue, Ste. 111, Medley, FL 33166 05/28/13 SSG

Miami-Dade Med One Medical Center Inc. 486 Fisherman, Opa Locka, FL 33054 06/17/13 SSG Miami-Dade Continuum Medical Group 18373 NW 27th Avenue, Miami Gardens, FL 33055 08/07/13 SSG Miami-Dade Latino Medical Center, Inc. 16600 NE 8th Avenue, North Miami Beach, FL 33162 08/07/13 SSG Miami-Dade Fox Medical Plaza of Homestead 1555 N. Krome Avenue, Homestead, FL 33030 08/20/13 SSG Miami-Dade ABC Pediatrics, P.A. 695 N. Krome Avenue, Homestead, FL 33030 12/31/13 SSG Miami-Dade Celebrity Rehab & Medical Center 50 Northwest 15th Street, Ste. 101, Homestead, FL 33030 03/24/14 SSG Miami-Dade Florida Medical Center & Research, Inc. 1501 Northwest 36th Street, Miami, FL 33142 04/22/14 SSG Miami-Dade L.S.L. Medical Center, Inc. 7175 Southwest 8th St., Ste. 213 & 214, Miami, FL 33144 05/12/14 SSG Miami-Dade Saludmed Healthcare Center, LLC 8260 West Flagler Street, Ste. 1-A, Miami, FL 33144 05/16/14 SSG Miami-Dade Lissette Selem, MD, PA 909 North Krome Avenue, Homestead, FL 33030 05/16/14 SSG Miami-Dade Rodriguez-Garcia Fredesvindo, MD/DBA Silver

Medical Center 815 Northwest 57th Avenue, Ste. 150, Miami, FL 33126 05/27/14 SSG


4/07/2015


Method of Approval

Miami-Dade Physician Office of Florida City, Inc. 646 West Palm Drive, Florida City, FL 33034 06/20/14 SSG Miami-Dade 8th Street Medical Center, Inc. 825 Southwest 87th Avenue, Ste C2, Miami, FL 33174 06/25/14 SSG Miami-Dade Zair Medical Service, Inc. 8660 West Flagler Street, Ste. 205, Miami, FL 33144 07/08/14 SSG Miami-Dade New Health Rehabilitation Center, Corp. 8660 West Flagler Street, Ste. 121, Miami, FL 33144 07/08/14 SSG Miami-Dade Coral Medical Rehab. Center, Inc. 9776 Coral Way, Miami, FL 33165 07/08/14 SSG Miami-Dade Opa-Locka Pain Management, Corp.

DBA Opa Medical Group 1865 Northeast 163rd Street, North Miami Beach, FL 33162 07/02/14 SSG

Miami-Dade Blue Line Diagnostics/DBA Med Rehab of Florida 8660 West Flagler Street, Ste. 102, Miami, FL 33144

08/25/14 SSG

Miami-Dade Ramon Maldonado, MD, PA 45 Northeast 9th Court, Homestead, FL 33030 09/16/14 SSG Miami-Dade Liberty Bell Group, Inc. 8768 SW 8th St., Ste. 10, Miami, FL 33174 305-222-6002 09/18/14 SSG Miami-Dade Doctor’s Medical Center, Inc. 7900 Northwest 27th Avenue, Ste. 150, Miami, FL 33147

1272 Northwest 119th Street, Miami, Florida 33167 5521 Southwest 8th St, Miami, FL 33134 4105 Northwest 135th Street, Opa Locka, FL 33054 5535 Southwest 8th St, Miami, FL 33134 26085 South Dixie Highway, Naranja, FL 33032 4888 Northwest 183rd Street, Ste. 100, Miami, FL 33055 1100 Northeast 125th St. Ste. 100, North Miami, FL 33161 2901 Northwest 17th Ave. Miami, FL 33142 1240 Northwest 119th St. Miami, FL 33167

10/08/1410/08/1410/08/1410/08/1410/08/1410/08/1410/08/1410/08/1410/08/14

10/21/14

SSG SSG SSG SSG SSG SSG SSG SSG SSG SSG

Miami-Dade Doctors Care & Prevention, PLLC 9624 Southwest 24th St., Miami, FL 33165 10/24/14 SSG Miami-Dade Comprehensive Medical Access, Inc.

DBA Centros Medicos Las Americas 11865 Southwest 26th St., Ste. G10 Miami, FL 33175

11/03/14 SSG

Miami-Dade Open Door Health Center, Inc. 1350 Southwest 4th St, Homestead, FL 33030 11/19/14 SSG Miami-Dade Family Care Rehab Group Corp. 3663 Southwest 8th St., Ste. 214 Miami, FL 33135 11/19/14 SSG Miami-Dade Miami Behavioral Health Center, Inc DBA

Bayan Health Systems 3850 West Flagler St., Miami, FL 33134 3800 West Flagler St., Miami, FL 33134

11/19/14 SSG

Miami-Dade Miami Behavioral Health Center, Inc

1566 Southwest First Street Miami, FL 33135 1560 Southwest First Street Miami, FL 33135 10720 Caribbean Blvd., Ste., 420 Cutler Bay, FL 33189

11/19/14 SSG

Miami-Dade Banyan Community Health Center, Inc. 3733 West Flagler Street Miami, FL 33134 10 Northwest 42nd Ave. Suite 500 Miami, FL 33126

11/19/14 SSG

Miami-Dade Spectrum Programs, Inc. 140 Northwest 59th St. Miami, FL 33127 120 Northwest 59th St. Miami, FL 33127

11/19/14 SSG


4/07/2015


Method of Approval

Miami-Dade South Psychological & Physical Rehabilitation, Inc

1408 Northeast 1st Avenue Homestead, Florida 33030

12/18/14 SSG

Miami-Dade Nemesis Medical Group, Inc. 1200 Northwest 78th Ave, Suite 212 Miami, Florida 33126 12/18/14 SSG Miami-Dade Dr. Jalal Taslimi Medical Center, Inc. 3940 West Flagler Street, Suite 202 Miami, Florida 33134 12/19/14 SSG Miami-Dade Comprehensive Medical Access, Inc.

8000 Biscayne Boulevard, First Floor Miami, Florida 33138

12/19/14 SSG

Miami-Dade La Benefica Medical Center 434 Southwest 12th Avenue, Suite 103 Miami, FL 33130

12/19/14 SSG

Miami-Dade Spring Medical Center, LLC 434 Southwest 12th Ave, Suite 402 Miami, Florida 33130 1/7/15 SSG Miami-Dade Med/Care Quality Medical Centers, LLC 10982 Southwest 184th St. Miami, FL 33158 1/7/15 SSG Miami-Dade CAC-Florida Medical Centers, LLC 6269 Northwest 7th Avenue Miami, Florida 33150

650 North Homestead Boulevard Homestead, Florida 33030 1/27/15 SSG

Miami-Dade Providence Medical Center, Inc. 10348 West Flagler Street Miami, Florida 33174 2/12/15 SSG Miami-Dade Resource Community Health Center, Inc. 759 Northwest 22nd Avenue, Suite 202 Miami, Florida

33125 2/12/15 SSG

Miami-Dade Primary Medical Care Center and Urgent Care Clinic, Inc.

11500 Northwest 7th Avenue Miami, Florida 33168

02/26/15 SSG

Miami-Dade Miami Rescue Mission Clinic, Inc. 2015 Northwest First Avenue 02/26/15 SSG Miami-Dade Miguel A. Aponte, MD 8100 West Flagler, Suite 101 Miami, Florida 33144 03/17/15 SSG Miami-Dade Advance Medical Research Center 330 Southwest 27th Avenue, Suite 701 Miami, FL 33135 03/24/15 SSG Monroe Monroe County Health Department 5100 College Road, Key West, FL 33041 305-293-7544 4/23/04 CHD Nassau Barnabas Center, Inc. 11 S. 11th St, Fernandina Beach, FL 32034 (904) 261-7000 4/8/06 VHCPP Nassau Nassau County Health Department

- Fernandina Beach Clinic - Callahan Clinic - Hilliard Clinic - Yulee Clinic - Dental Clinical

30 S. 4th Street, Fernandina Beach, FL 32035 1620 Nectarine St, Fernandina Bch, FL 45377 Mickler St, Callahan, FL 32011 37203 Pecan St, Hilliard, FL 32046 528 Page’s Dairy Rd, Yulee, FL 32097 Yulee Full Service School, 479 Felmore Rd, Yulee, FL 32097

904-548-1800 904-548-1860 904-879-2306 904-845-4761 904-548-1880 904-548-1849

CHD

Nassau MCCI Group Holdings, Callahan Medical Center

449621 US Highway 301, Ste. 110, Callahan, FL 32011 904-507-2692 12/7/11 SSG

Okaloosa

Okaloosa County Health Department

221 Hospital Drive, NE, Ft. Walton Beach, FL 32458 850-389-3015 CHD

Okaloosa Crossroads Center Medical Clinic 444 Valparaiso Pkwy, Bldg C, Valparaiso, FL 32580 850-226-6928 VHCPP Okaloosa Coast Family Clinic 4100 S. Ferdon Blvd., Ste. A-4, Crestview, FL 32536 850-867-0313 05/11/12 SSG Okeechobee Okeechobee County Health Department 1728 NW 9th Avenue, Okeechobee, FL 34972 941-462-5819 CHD


4/07/2015


Method of Approval

Orange Lake

Community Health Centers, Inc. - Apopka Children’s Health Center - Apopka Family Health Center - Eatonville Dental Facility - Leesburg Community Health Center - Pine Hills Family Health Center - S. Lake Family Health Center - Winter Garden Children’s Health Center - Winter Garden Family Health Center - Lake Ellenor Dental

110 S. Woodland Street, Winter Garden, FL 34787 618 Forest Ave., Apopka, FL 32703 225 E. Seventh Street, Apopka, FL 32703 434 W. Kennedy Blvd., # D, Eatonville, FL 32810 225 N. 1st St., Leesburg, FL 34748 1800 Mercy Drive, Ste 200, 2nd Floor, Orlando, FL 32808 1296 Broad St., Groveland, FL 34736 110 S. Woodland St., Winter Garden, FL 34787 110 S. Woodland St., Winter Garden, FL 34787 6101 Lake Ellenor Dr, Orlando, FL 32809

407-905-8827 407-886-6201 407-886-6201 407-645-3959 352-360-0490 407-209-3202 352-429-4104 407-877-4340 407-877-4340

2/4/94 s. 330

Orange Ombudsman Council District 7 FL Dept. of Children and Families, Dist. 7, Orlando 407-245-0640

Orange Orange County Public Health Department - Orange County Health Department - Orange County Health Department, Central - Orange County Health Dept, Eastside - Orange County Health Department - Orange County Health Department - Lila Mitchell, Orlando - Oak Ridge, Orlando

604 Courtland St., # 200, Orlando, FL 32804 1111 N. Rock Springs Rd., Apopka, FL 32712 832 W. Central Blvd., Orlando, FL 32805 12050 E. Colonial Dr., Orlando, FL 32826 475 W. Story Rd., Ocoee, FL 34761 941 W. Morse Blvd., Winter Park, FL 32789 5151 Raleigh St., Orlando, FL 32811 2346 W. Oak Ridge Rd., Orlando, FL 32809

407-623-1180 407-654-1072 407-836-2600 407-296-5177 407-667-6262 407-623-1151 407-296-5177 407-858-4731

4/8/94 CHD

Orange Shepherd's Hope, Inc. 4851 S. Apopka-Vineland Road, Orlando, FL 32819 407-876-6729 2/4/00 VHCPP Orange Special Care, Inc. 101 S. Westmoreland Drive, Orlando, FL 32805 407-836-2519 2/5/05 VHCPP Orange Health Care Center for the Homeless, Inc.

Administrative Offices Orange Blossom Family Care Center

232 N Orange Blossom Trail, Orlando, FL 32805

407-428-5751

s. 330

Orange Orlando Family Physicians Jorge L. Garcia, President/CEI

1130S. Semoran Blvd, Orlando, FL 32807 407-382-1376 11/13/07 Secretary

Orange Catholic Charities of Central Florida, Inc.; St. Thomas Aquinas Free Medical Clinic

1771 N Semoran Blvd, Orlando, FL 32807 mailing 510 Brown Chapel Rd, St. Cloud, FL 34769

407-658-1818

8/13/08 VHCPP

Orange Central Florida Family Health Center, Inc. 2400 SR 415, Sanford, FL32771 11881-A E Colonial Dr, Orlando, FL 32826 5449 S Semoran Blvd, #15, Orlando, FL 32822 5730 Lake Underhill Rd, Orlando, FL 32807 6101 Lake Ellenor Dr #105, Orlando, FL 32809

407-322-8645 407-275-4048 407-207-7756 407-956-4320 407-956-4680

9/17/08 Board approved

Orange Orlando Family Medical Center 1718 Woolco Way, Orlando, FL 32822 11/4/2010

SSG


4/07/2015


Method of Approval

Orange Kenaday Medical Clinic 6001 Silver Star Rd, Ste 1A-1B, Orlando, FL 32808 12/13/2010

SSG

Orange Miracle Health Center of Winter Garden 321 Dillard St, Winter Garden, FL 34787 2/11/2011

SSG

Orange Central Florida Primary Physicians, LLC 7901 Kingspointe Pkwy, Ste 1, Orlando, FL 32819 4/13/2011

SSG

Orange Central Florida Primary Physicians, LLC 7806 Lake Underhill Road, Ste 105, Orlando, FL 32822 7/13/2011

SSG

Orange Physicians Care Plus of Orlando 600 N Hart Blvd, Orlando, FL 32818 4/13/2011

SSG

Orange Dr. Borges Medicine and More 1800 W Oakridge Rd, Orlando, FL 32809 5/3/2011 SSG Orange USA Medical Care LLC 5608 Pershing Ave, Orlando, FL 32822

3900 South Goldenrod Street, Orlando, FL 32822 1800 West Oak Ridge Road, Orlando, FL 32809

407-935-0623 03/06/1309/05/1409/05/14

SSG SSG SSG

Orange American HealthCare Clinic American HealthCare Clinic

100 S Semoran Blvd, Orlando, FL 32807 7975 Lake Underhill Rd., Ste. 240, Orlando, FL 32822

6/10/1109/25/12

SSG SSG

Orange Threshold Center for Autism 3550 North Goldenrod Road, Winter Park, FL 32792 8/16/11 SSG Orange R. Rosario-Medina, M.D., L.L.C. 4711 Curry Ford Road, Orlando, FL 32812 407-382-9703 10/19/11 SSG Orange Grace Medical Home 51 Pennsylvania Street, Orlando, FL 32806 407-936-2785 12/21/11 SSG Orange Primary Healthcare Associates 5273 Curry Ford Road, Orlando, FL 32812 407-933-1760 05/17/12 SSG Orange Unique Healthcare of Orlando Family Medicine 4978 Millenia Blvd., Orlando, FL 32839 407-601-7840 05/17/12 SSG Orange My Family Doctor of Orlando, LLC 5575 South Semoran Blvd., Ste. 26, Orlando, FL 32822 407-401-8637 06/15/12 SSG Orange Lahens Medical Center, Inc. 1140 S. Semoran Blvd., Ste. E, Orlando, FL 32807 407-384-9165 12/10/12 SSG Orange Gutierrez Medical Center, LLC 5804 Lake Underhill Rd., Ste. A, Orlando, FL 32807 787-505-9989 02/22/13 SSG Orange PCA Medical Group 1140 S. Semoran Blvd., Ste. C, Orlando, FL 32807

6003 Silver Star Rd., Ste. 2, Orlando, FL 32808 407-281-9105 407-522-5311

02/22/1302/22/13

SSG SSG

Orange Florida Family Physicians LLC 2840 North Hiawassee Rd., Ste. 428, Orlando, Florida 32818 04/03/13 SSG Orange Sand Lake Health and Wellness Center, LLC 2345 Sand Lake Rd., Ste. 200, Orlando, FL 32809 08/30/13 SSG Orange Pinero Preventive Medical Care PA 1720 S. Orange Avenue, Ste. 200, Orlando, FL 32806 09/10/13 SSG Orange Medical Home Alliance, LLC

dba IMA Medical Center 1320 N. Semoran Blvd., Ste. 204, Orlando, FL 32807 7901 Kings Pointe Parkway, Ste. 1, Orlando, FL 32819 1277 North Semoran Boulevard, #104 Orlando, Florida 32807

11/15/1303/25/14

03/17/15

SSG SSG SSG

Orange Integrated Chiropractic Healthcare, PA 1023 S. Dillard Street, Winter Garden, FL 34787 12/13/13 SSG Orange First Care Chiropractic & Family Practice Center 1011 West Oak Ridge Road, Ste. A, Orlando FL 32809 03/28/14 SSG


4/07/2015


Method of Approval

DBA First Care Pediatrics Orange Piecar Community Health Care, LLC 6388 Silver Star Road, Orlando, FL 32818 10/17/13 SSG Orange Orlando Family Physicians, LLC 810 North Nowell Street, Orlando, FL 32808 05/05/14 SSG Orange Prime Care Family Health Centers, Inc. 1339 Arlington Street, Orlando, FL 32805

1706 East Semoran Blvd, Ste. 101, Apopka, FL 32703 37 South Semoran Blvd., Orlando, FL 32807

07/11/1407/11/1407/11/14

SSG SSG SSG

Orange Compassion Pediatrics, LLC 4442 Curry Ford Road, Orlando, FL 32812 07/11/14 SSG Orange Express Global Medical Services, LLC 12200 West Colonial Drive, Winter Garden, FL 34787 09/25/14 SSG Orange Integrated Medical Center 7824 Lake Underhill Rd, Ste. A Orlando, FL 32822 10/21/14 SSG Orange AHCMC, LLC 672 North Semoran Blvd. #201, Orlando, FL 32807 11/17/14 SSG Orange Advanced Physical Medicine, Inc. 953 North Semoran Blvd. Orlando, FL 32807 11/19/14 SSG Orange Digestive and Liver Center of Florida, PA 100 North Dean, Ste. 101,Orlando, FL 32825 11/19/14 SSG Orange Unlimited Medical Services of Florida 5580 East Grant Street Orlando, Florida 32822 11/18/14 SSG Orange CAC-Florida Medical Centers, LLC 5235 West Colonial Drive Orlando, Florida 32808 1/27/15 SSG Orange Mid Florida Adult Medicine, LLC 7824 Lake Underhill Road, Suite B Orlando, Florida 32822 02/26/15 SSG Orange Hispanic Family Counseling, Inc. 6900 South Orange Blossom Trail Ste. 402 Orlando, FL

32809 03/31/15 SSG

Orange My Endocrinologist, PA 213 South Dillard St, Suite 240 Winter Garden, FL 34787-3596

03/31/15 SSG

Osceola Health Group Center Inc. 3358 W. Southport, Kissimmee, FL 34746 407-267-8823 07/19/12 SSG Osceola Mental Health Services of Osceola County, Inc.

917 Emmett Street, Kissimmee, FL 34742-1826

407-846-0023

6/6/92

Osceola Orlando Family Medical, Inc. 931 W Oak St, Ste 103, Kissimmee, FL 34741 407-931-0444 3/9/04 SecretaryOsceola Poinciana Primary Health Care 105 N. Dover Plum Avenue, Poinciana, FL 34758 407-943-8600 s. 330 Osceola

Osceola County Health Department - Center for Women and Family Health at Stadium Place Osceola County Hlth Dept, St. Cloud

1875 Boggy Crk Rd, P.O. B. 450309,Kissimmee, FL 347451505 Bill Beck Blvd., Kissimmee, FL 34744 1050 Grape Ave., St. Cloud, FL 34769

407-343-2020 407-343-2050 407-892-2973

CHD

Osceola Project Access 8000 Biscayne Blvd, Miami, FL 33138 11865 SW 26th ST, Unit G-10, Miami, FL 33174 6830 Pines Blvd, Pembroke Pines, FL 33024 1609 E Vine St, Kissimmee, FL 34744 7206 N Armenia Ave, Tampa, FL 33603 7000 SW 62nd Ave, Ste 300, S. Miami, FL 33143 5240 West Flagler St, Miami, FL 33124 700 SW 8 Street, Miami, FL 33130

305-759-4778 305-559-8333 954-987-5010 407-944-1319 813-933-2800

Secretary 1/25/06


4/07/2015


Method of Approval

Osceola Osceola County Council on Aging 1099 Shady Lane, Kissimmee, FL 34744 406-846-8550 8/3/02 VHCPP Osceola Latin Foundation for Health, Inc 721 Oak Commons Blvd, Ste B, Kissimmee, FL 34741 305-228-1940 9/1/2010 SSG Osceola Kenaday Medical Clinic 1901 S John Young Parkway, Ste 103, Kissimmee, FL

34741 12/13/20

10SSG

Osceola Kenaday Medial Clinic 1966 S. John Young Parkway, Kissimmee, FL 34741 12/13/2010

SSG

Osceola Kenaday Medical Clinic 1122 N Main St, Kissimmee, FL 34744 12/13/2010

SSG

Osceola Kenaday Medical Clinic 814 N John Young Parkway, Kissimmee, FL 34741 11/15/11 SSG Osceola Kidsville Pediatrics II 1050 W Carroll St, Kissimmee, FL 34741 10/26/20

10SSG

Osceola Orlando Family Physicians 505 W Oak St, Kissimmee, FL 34741 2/4/2011 SSG Osceola Orlando Family Physicians 104 Buenaventura Ave, Kissimmee, FL 34741 2/4/2011 SSG Osceola Orlando Family Physicians, LLC 790 Buenaventura Ave, Kissimmee, FL 34743 04/29/14 SSG Osceola Central Florida Primary Physicians, LLC 4545 Pleasant Hill Rd, Ste 112, Kissimmee, FL 34759 2/21/201

1SSG

Osceola Dr. Borges Medicine and More 1207 E Vine St, Kissimmee, FL 34744 5/3/2011 SSG Osceola I Care Clinic, LLC 3262 Vineland Rd, Ste 102, Kissimmee, FL 34746 5/16/201

1SSG

Osceola Gutierrez-Perez Family Medicine 907A N Central Ave, Kissimmee, FL 34741 5/18/11 SSG Osceola Best of Health Medical Clinic 524 13th Street, St. Cloud, FL 34769

3900 South Goldenrod Road, Ste. 142, Orlando, FL 32822 407-593-2814

06/22/1104/18/13

SSG SSG

Osceola B & T Medical Center, LLC 988 East Osceola Parkway, Kissimmee, FL 34744 7/13/2011

SSG

Osceola Quality Life Health Center 804 Emmett Street, Kissimmee, FL 34741 8/31/11 SSG Osceola Osceola MediClinic 2497 Trafalgar Blvd., Kissimmee, FL 34758 407-350-4844 06/06/12 SSG Osceola Providence Community Health Center 201 Hilda Street, Kissimmee, FL 34741 954-461-5981 01/05/12 SSG Osceola Primary Health Care Associates, Inc. 308 W. Bass Street, Kissimmee, FL 34741 407-933-1760 06/12/12 SSG Osceola Acute Patient Care 1032 Mann Street, Kissimmee, FL 34741 863-585-9627 11/07/12 SSG Osceola VIP Family Practice 401 West Oak Street, Kissimmee, FL 34741 407-730-9911 01/14/13 SSG Osceola Florida Sports & Family Health Center 309 West Bass Street, Kissimmee, FL 34741 407-483-1087 04/18/13 SSG Osceola USA Medical Care LLC 1962 North John Young Parkway, Kissimmee, FL 34741 05/08/13 SSG Osceola Carrousel Therapy Center Corporation &

Carrousel Behavioral Health Services 4898 East Irlo Bronson Memorial Hwy., 2nd Floor, St. Cloud, FL 34771

08/26/13 SSG

Osceola Poinciana Medical Clinic, Inc. 51 N. Doverplum Avenue, Kissimmee, FL 34758 1952 East Osceola Parkway, Kissimmee, FL 34743

10/09/1310/01/14

SSG SSG

Osceola The Family Physicians of BVL 3071 Michigan Avenue, Kissimmee, FL 34744 10/15/13 SSG


4/07/2015


Method of Approval

Osceola Physicians Care Centers of Kissimmee, LLC 595 Oak Commons Blvd., Ste. A, Kissimmee, FL 34741 12/03/13 SSG Osceola USA Medical Care, LLC 524 13th Street, St. Cloud, FL 34769 02/21/14 SSG Osceola BVL Pediatrics Best Pediatrics Care, LLC 2535 Boggy Creek Road, Kissimmee, FL 34743 02/26/14 SSG Osceola Teamwork International, Corp.

DBA HealthCareZone 1082 Cypress Parkway, Kissimmee, FL 34759 03/28/14 SSG

Osceola Medical Home Alliance, LLC, dba IMA Medical Center

4543 Pleasant Hill Road, Ste. A, Kissimmee, FL 34759 1033 Plaza Drive, Kissimmee, FL 34743

04/25/1406/03/14

SSG SSG

Osceola LPS Medical Group/LPS Medical Group, LLC 1310 North Main Street, Ste. 105, Kissimmee, FL 34744 05/12/14 SSG Osceola Vineland Medical Care, LLC 1319 East Vine Street, Kissimmee, FL 34744 05/16/14 SSG Osceola Chappel Family Practice, LLC 222 Broadway Avenue, Ste. 301 Kissimmee, FL 34741 06/16/14 SSG Osceola Primary HealthCare Associates of Osceola

Parkway, Inc 1000 East Osceola Parkway, Kissimmee, FL 34744 06/25/14 SSG

Osceola Primary HealthCare Associates of BVL, Inc. 3071 Michigan Avenue, Kissimmee, FL 34744 06/25/14 SSG Osceola Asthma, Allergy & Immunology, PA 903 West Oak Street, Kissimmee, FL 34741 09/16/14 SSG Osceola Family Physicians of Saint Cloud, PA DBA Pro

Health Family Physicians 3100 17th St., Saint Cloud, FL 34769 7264 Harmony Square Drive South, Harmony, FL 34773

10/24/14

10/24/14

SSG SSG

Osceola AHCMC, LLC 833 East Oak Street, Kissimmee, FL 34744 11/17/14 SSG Osceola Pro Health Heritage Square, LLC DBA Pro

Health Family Physicians 819 East Oak Street Ste., A Kissimmee, FL 34744 12/04/14 SSG

Osceola Kissimmee Medical Specialties 701 East Oak Street, Suite A Kisimmee, FL 34744 12/04/14 SSG Osceola Aviva Health and Wellness Clinic DBA Aviva

Healthcare, Inc.

353 Cypress Parkway Kissimmee, Florida 34759

12/18/14 SSG

Osceola Family Health Clinic USA, LLC 323 West Oak Street, Suite A Kissimmee, Florida 34741

12/18/14 SSG

Osceola Comprehensive Medical Access, Inc. DBA Centros Medicos Las Americas

1609 East Vine Street Kissimmee, Florida 34744

12/19/14 SSG

Osceola Medcare Xpress Walk-In Clinic of Kissimmee, LLC

1122 North Main St. Kissimmee, FL 34746

1/27/15 SSG

Osceola Vivian Charneco, MD, PA, LLC 719 East Oak Street Kissimmee, Florida 34744 03/31/15 SSG Palm Beach The Jerome Golden Center for Behavioral

Health, Inc. 1041 45th Street, West Palm Beach, FL 33407 561-383-8000 04/29/13 SSG

Palm Beach Child Protection Team of Palm Beach 2840 Sixth Ave., South, Lake Worth, FL 33407

561-433-3544 7/17/99 Under contract w/ DOH

Palm Beach Hospice of Palm Beach County, Inc. 5300 E Ave., West Palm Beach 33407-2387 407-848-5200 10/2/94 Palm Beach Caridad Center (previously Migrant Association 8645 W. Boynton Beach Blvd, Boynton Beach, FL 33437 561-737-6336 VHCPP


4/07/2015


Method of Approval

of South Florida, Inc. /Caridad Health Campus) Palm Beach Palm Beach County Health Department

- C.L. Brumback Health Center - Delray Beach Health Clinic -Jupiter Health Center -MyClinic - Lantana/Lake Worth Health Center - Riviera Beach Health Center - West Palm Beach Health Center

826 Evernia St., West Palm Beach, FL 33401 38754 State Rd. 80, Belle Glade, FL 33430 225 S. Congress Avenue, Delray Beach, FL 33444 6405 Indiantown Road, Jupiter, FL 33458 6405 Indiantown Road, Ste.B, Jupiter, FL 33458 1250 Southwinds Drive, Lantana, FL 33462 7289 Gardens Rd, Riviera, FL 33404 1150 45th Street, West Palm Beach, FL 33407

561-355-3120 561-882-3200 561-996-1600 561-274-3100 561-746-6751 561-547-6800 561-653-2000 561-514-5300

02/26/14

CHD SSG

Palm Beach Brito Medical Center 2070 S Military Trl, West Palm Beach, FL 33415 2/4/2011 SSG Palm Beach RMA Medical Centers of Florida, LLC 6432 Lake Worth Rd, Lake Worth, FL 33463 5/18/11 SSG Palm Beach Fatima Medical Center 1800 Forest Hill Blvd, Ste B-9, West Palm Beach, FL

33406 7/13/11 SSG

Palm Beach ACN Baromedical, LLC 1702 South Dixie Highway, Unit 2, Lake Worth, FL 33460 954-328-2521 01/05/12 SSG Palm Beach Community Health Center 2823 N. Australian Avenue, West Palm Beach, FL 33407 561-840-8681 09/04/12 SSG Palm Beach Lake Ida Medical Center 2605 W. Atlantic Ave., Ste.D101, Delray Beach, FL 33445 561-279-0991 12/10/12 SSG Palm Beach Guadalupe Medical Center, Inc. 4469 South Congress Ave, Ste. 106, Lake Worth, FL 33461 954-292-6217 10/30/12 SSG Palm Beach Drug Abuse Foundation of Palm Beach County,

Inc. 400 South Swinton Avenue, Delray Beach, FL 33444 561-278-0000

x398 01/14/13 SSG

Palm Beach MD Chiro Zone 3951 N. Haverhill Rd, Ste. 218, West Pam Beach, FL 33417 06/11/13 SSG Palm Beach American Care of South Florida, Inc. 1301 South Main Street, Belle Glade, FL 33430

3342 Broadway, Riviera Beach, FL 33404 02/13/14

02/26/14SSG SSG

Palm Beach Palm Beach County Medical Society, Inc. 3540 Forest Hill Blvd., Ste. 101, West Palm Beach, FL 33406 08/04/14 SSG Palm Beach Pasqual Health Services, LLC 1201 South Federal Highway Lake Worth, Florida 33460 03/24/15 SSG Pasco CARES (Community Aging & Retirement

Services, Inc.) 7505 Rottingham Rd, Pt. Richey, FL 34668-2648 727-862-9291

or 352-523-1500

6/6/92 VHCPP

Pasco Premier Community Healthcare Group - Dade City Family & Dental Health Center - Summit Women’s Health Center - Zephyrhills Children’s Health Center - Zephyrhills Family Health Center

37946 Church Avenue, Dade City, FL 33525 37944 Church Avenue, Dade City, FL 33525 10605 US Hwy. 301, Dade City, FL 33525 37918 Medical Arts Ct., Zephyrhills, FL 33541 37922 Medical Arts Ct., Zephyrhills, FL 33541

352-518-2000 352-518-2006 352-567-2606 813-780-1037 813-782-2350

s. 330

Pasco Pasco County Health Department - Family Services - Family Health Services - Family Health Services

10841 Little Rd, New Pt Richey, FL 34654-2533 Bldg. A, 10841 Little Rd., New Pt Richey, FL 34654 6701 Forest Ave., New Port Richey, FL 34652 11511 Denton Ave., Hudson, FL 34667

813-869-3900 727-862-0782 727-816-1100 727-863-2444

CHD


4/07/2015


Method of Approval

- Family Health Services - Family Health Services - Family Health Services

13941 15th St., Dade City, FL 33525 4717 Airport Road , Zephyrhills, FL 33540 4135 Land O’ Lakes Blvd., Land O’ Lakes, FL 34639

352-521-1450 813-782-1740 813-588-5173

Pasco Good Samaritan Health Clinic of Pasco, Inc. 5334 Aspen St., New Port Richey, FL 34652 727-848-7789 12/08 VHCPP Pasco Wesley Chapel Medical Clinic 5819 Argerian Drive, Wesley Chapel, FL 33545 10/08/12 SSG Pasco PCA Medical Group 6610 Embassy Rd., Ste. B, Pt. Richey, FL 34668

6239 Fort King Rd. , Zephyrhills, FL 33542 727-817-0239 813-783-3020

02/22/1302/22/13

SSG SSG

Pasco Esteban Alfonzo Ruiz, M.D., P.A. 8813 River Crossing Blvd., New Port Richey, FL 34655 08/23/13 SSG Pasco S&Y Ventures DBA Bella Med Spa 1821 Bruce B. Downs Blvd., Unit 120, Wesley Chapel, FL

33544 12/30/13 SSG

Pasco Baby Steps Health, Inc. 6610 Embassy Boulevard, Suite A Port Richey, Florida

34668 12/18/41 SSG

Pinellas Clearwater Free Clinic 707 N. Fort Harrison Ave, Clearwater, FL 33755 727-447-3041 6/1/90 VHCPP Pinellas Willa Carson Health And Wellness Center, Inc. 1108 N Martin Luther King Ave, Clearwater, FL 33755 727-467-9411 4/7/15 SSG Pinellas Community Health Centers of Pinellas

- Johnnie Ruth Clarke - - Community Health Centers at Tarpon Springs

1344 22nd Street South, St. Petersburg, FL 33712 1344 22nd Street South, St. Petersburg, FL 33712 301 S. Disston Avenue, Tarpon Springs, FL 34689

727-821-6701 727-821-6701 727-944-3828

s. 330

Pinellas Pinellas County Department of Social Services (Homeless Center)

647 First Avenue, North, St. Petersburg, 33701 727-582-7595 s. 330

Pinellas Pinellas County Health Department - Clearwater Center - Largo Health Center - Northeast High Clinic - Pinellas Park Center - St. Petersburg Center - Tarpon Springs Center

500 7th Ave., S., St. Petersburg, FL 33701-4820 310 N. Myrtle Ave., Clearwater, FL 12420 130th Ave. North, Largo, FL 33774 1717 54th Ave. North, St. Petersburg, FL 33714 6350 76th Ave. North, Pinellas Park, FL 33781 500 7th Ave. South, St. Petersburg, FL 33701 301 S. Disston Ave., Tarpon Springs, FL 34689

727-824-6931 727-469-5800 727-588-4040 727-570-3151 727-547-7780 727-824-6900 727-9425457

CHD

Pinellas St. Petersburg Free Clinic 863 3rd Ave. N., St. Petersburg, FL 33701 727-821-1200 4/8/94 Pinellas La Clinica Guadalupana, Inc. 1000 Lakeview Rd, Ste 4, Clearwater, FL 33756 727-461-7730 12/08 VHCPP Pinellas Pinellas County Jail 10750 Ulmerton Rd, Largo, FL 33779 727-582-6200 10/2010 Statute Pinellas First Knight Medical, Inc. 6279 Park Blvd. Pinellas Park, FL 33781 727-548-1232 10/19/12 SSG Pinellas PCA Medical Group 1501 Alternate 19, Ste. D, Tarpon Springs, FL 34689 727-934-5575 02/22/13 SSG Pinellas Clear Scope Healthcare, LLC 11300 U.S. 19th North, Clearwater, FL 33764 08/05/13 SSG Pinellas Florida Family Primary Care Centers of Pinellas,

LLC 6245 66th Street North, Pinellas Park, FL 33781 04/25/14 SSG

Pinellas Live Better Health Center, LLC 4423 Park Boulevard North Pinellas Park, FL 33781 11/19/14 SSG Pinellas Health Now Primary and Urgent Care 7599 Park Boulevard Pinellas Park, Florida 33781 03/31/15 SSG


4/07/2015


Method of Approval

Polk Lakeland Volunteers in Medicine 1021 Lakeland Hills Blvd, Lakeland, FL 33805 863-688-5846 6/4/01 VHCPP Polk Polk County Health Department

- AIDS Clinic, Lakeland - Auburndale Clinic, Auburndale - Bartow Clinic, Bartow - Haines City Clinic, Haines City - Lake Wales Clinic, Lake Wales - Mary Sand Clinic, Auburndale

1290 Golfview Ave. 4th Fl, Bartow, FL 33830 1805 Hobbs Road, Auburndale, FL 33823 2020 E. Georgia Ave., Bartow, FL 33830 111 11th St., Haines City, FL 33844 305 West Central Ave., Lake Wales, FL 33853 1805 Hobbs Road, Auburndale, FL 33823

863-519-7900 863-965-5400 863-519-7916 863-421-3204 863-678-4013 863-965-5400

CHD

Polk Central Florida Health Care – Lakeland 1729 Lakeland Hills Blvd, Lakeland, FL 33805 863-688-1528 9-07 Polk Central Florida Health Care

Lakeland Primary Care 950 CR 17A West, Avon Park, FL 33825 863-452-3004 9-07

Polk Polk General Hospital – Bartow 2010 E. Georgia St., Bartow, FL 33830 941-533-1111 Polk Trinity Medical Center 1064 N Broadway Ave, Bartow, FL 33830 863-519-9797 9/1/201 SSG Polk Kidsville Pediatrics I 2201 North Boulevard W, Davenport, FL 33837 10/26/20

10SSG

Polk Parkview Medical Clinic 1205 Dr. Martin Luther King, Jr., Way, Haines City, FL 33844

4/13/2011

SSG

Polk Doctor Today TLC LLC Doctor Today TLC LLC Doctor Today TLC LLC Doctor Today TLC LLC Doctor Today TLC LLC

3810 South Florida Avenue, Lakeland, FL 33813 4435 US 98 North, Lakeland, FL 33809 602 Avenue K SE, Winter Haven, FL 33880 1429 Lakeland Hills Blvd., Lakeland, FL 33805 700 First Street South, Winter Haven, FL 33880 101 Magnolia Avenue, Auburndale, FL 33823 602 US Highway 17-92 North, Haines City, FL 33844

863-619-5100 863-687-0200 863-401-2807 863-687-0200 863-687-0200

05/11/1205/11/1205/11/1205/11/1208/10/1210/15/1303/25/14

SSG SSG SSG SSG SSG SSG SSG

Polk Physician’s Services LLC Physician’s Services LLC Physician’s Services LLC

35600 US Highway 27 North, Haines City, FL 33844 1143 SR 60 East, Lake Wales, FL 33853 6800 Cypress Gardens Blvd., Winter Haven, FL 33884 1045 US Highway 17 South Bartow, Florida 33830

863-679-8815 863-679-8815 863-679-8815

08/10/1208/10/1208/10/12

12/18/14

SSG SSG SSG SSG

Polk Acupuncture & Oriental Medicine 306 Avenue C, NE, Winter Haven, FL 33881 407-234-8780 10/19/12 SSG Polk Jay Care Medical Center 135 East First Street, Lakeland, FL 33805

5985 S. Florida Avenue, Lakeland, FL 33813 950 First Street S., Winter Haven, FL 33880 131 Webb Drive, Davenport, FL 33898

08/28/1308/30/1308/30/1309/17/13

SSG SSG SSG SSG

Polk Central Florida Cancer Institute, P.A. 40107 Highway 27, Davenport, FL 33837 08/30/13 SSG Polk Nuestra Sra. Del Carmen 306 S. 10th Street, Haines City, FL 33844 10/09/13 SSG Polk Nelson M. Pichardo, M.D., P.A./dba The

Pichardo Clinic 111 Webb Drive, Davenport, FL 33837 11/04/13 SSG


4/07/2015


Method of Approval

Polk Premier Care Professionals, Inc 4725 US Highway 98 South, Ste. 102, Lakeland, FL 33812 502 East Hinson Avenue, Haines City, FL 33844

11/15/1302/26/14

SSG SSG

Polk American Care of Tampa, Inc. 2791 Lake Alfred Road, Winter Haven, FL 33881 12/31/13 SSG Polk Advanced Internal Medicine Care, P.A. 5425 South Florida Avenue, Lakeland, FL 33813

1045 East County Road 540A Lakeland, Florida 33813 04/22/14

12/19/14SSG SSG

Polk Heart of Florida Medical Center 101 South Dixie Drive, Haines City, FL 33844 05/05/14 SSG Polk Internal Medicine Specialists Medical Group,

PA 427 East Central Avenue, Winter Haven, FL 33880 3655 Innovation Drive, Lakeland, FL 33812

05/27/1405/27/14

SSG SSG

Polk MPN Medical Center of Dundee, LLC 1023 Dundee Road, Dundee, FL 33838 07/18/14 SSG Polk Heartland Pediatrics of Lake Wales, LLC 1354 State Road 60 East Lake Wales, Florida 33853 02/26/15 SSG Putnam Alachua Clay

Family Medical & Dental Centers, Inc. - Crescent City Family Medical Center - Hawthorne Family Medical Center - Interlachen Family Medical Center - Palatka Family Dental Center - Palatka Family Medical Center - Keystone Heights

1302 River Street, Palatka, FL 32177 306 Union Ave., Crescent City, FL 32112 22018 SE 71st Ave., Hawthorne, FL 32640 1213 SR 20, Unit B, Interlachen, FL 32148 2503 President St., Palatka, FL 32177 2503 President St., Palatka, FL 32177 100 Commercial Dr, Keystone Heights, FL 32656

386-328-0108 386-698-1232 352-481-2700 386-684-4914 386-328-7638 386-328-8371 352-473-6595

12/8/96 s. 330

Putnam Putnam County Health Department 2801 Kennedy Street, Palatka, FL 32177-4100 386-326-3200 4/8/94 CHD Putnam Medical Specialists of Northeast Florida 800 Zeagler Dr, Ste 510, Palatka, FL 32177 2/4/2011 SSG Putnam Broward Outreach Center Pompano 1700 Blount Road, Pompano Beach, FL 33069 305-572-2026 05/17/12 SSG Putnam Premier Urgent Care Center/Internal

Medical/Urgent Care 2400 W. Sample Rd., Ste. 4, Pompano Beach, FL 33073-3035

05/08/13 SSG

Putnam North Central Florida Hospice, Inc./DBA Haven Hospice/Roberts Hospice Care Center

6400 Saint Johns Avenue, Palatka, FL 32177 03/07/14 SSG

Putnam Jean-Claude Dubois, MD, PA 601 East Sample Road, Ste. 110, Pompano Beach, FL 03/17/14 SSG Santa Rosa Santa Rosa County Health Department

- Gulf Breeze Health Department - Jay Health Department -Santa Rosa Beach Clinic

P.O. Box 929, Milton, FL 32572-0929 5840 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 215 Alabama St., Jay, FL 32565 194 N Cnty Hwy 393, Santa Rosa Bch, FL 32459

850-983-5200 850-934-4074 850-675-4211 850-267-35982

CHD

Santa Rosa Santa Rosa Community Clinic 5520 Stewart Street Milton, Florida 32570

1/27/15 SSG


4/07/2015


Method of Approval

Sarasota

Sarasota County Health Department P.O. Box 2658, Sarasota, FL 34230-2658 1750 17th St., Sarasota, FL 34234 2400 Colson Ave., Sarasota, FL 34234 7820 S. Tamiami Trail, Bldg. B2, Venice, FL 34293

941-954-2900 941-316-1015 941-361-6934 941-493-3830

N/A CHD

Sarasota Genesis Health Services, Inc. 3333 N Washington Blvd., Ste. 3, Sarasota, FL 34234 941-363-1852 12/01/01 SSG Sarasota Community Medical Clinic (Sarasota Memorial

Hospital) 1700 S. Tamiami Trail, FL 34239 941-917-6364 12/3/93

Sarasota Lee Collier

Senior Friendship Centers, Inc. 1888 Brother Geenen Way, Sarasota, FL 34236 1900 Brother Geenen Way, Sarasota, FL 2350 Scenic Dr, Venice, FL 27420 Voyageur Dr, Harbor Heights, FL 33983 2171 Pine Ridge Road, Suite F, Naples, FL 34109 23 N Polk Ave, Arcadia, FL 34266 3600 Evans Ave, Ft. Myers, FL 33901

941-955-2122 941-556-3220 941-584-0041 941-743-5353 239-566-7425 863-494-5965 239-275-1881

4/8/94

08/22/12

SSG

Seminole Seminole County Health Department 400 W. Airport Boulevard, Sanford, FL 32773 Goodings Plaza Office Center, 132 Sausalito Boulevard, Casselberry, FL 32707-5764

407-322-2724 407-665-3400

CHD

Seminole John E. Polk Correctional Facility-Seminole County Sheriff’s Office

211 Bush Blvd., Sanford, FL 32773 8/19/11 SSG

Seminole Orange

Central Florida Family Health Center, Inc. - Central FL Family Health Center - Hoffner - Central FL Family Health Center - Alafaya

2400 CR 415-A, Sanford, FL 32771 5549 S. Semoran Blvd., #14, Orlando, FL 32822 11881-A East Colonial Drive, Orlando, FL 32826

407-322-8645 407-207-7756 407-275-4048

2 s. 330

Seminole First Choice Pediatrics – Sanford 1403 Medical Plaza Drive, Suite #104, Sanford, FL 32771 407-249-1234 10/19/12 SSG St. Johns St. Johns County Health Department 1955 US Highway 1, #100, St. Augustine, FL 32086 904-825-5054 CHD St. Johns Good Samaritan Health Centers, Inc PO Box 1005, St. Augustine, FL 904-829-1962 2/09 VHCPP St. Johns Medical Specialists of Northeast Florida

Medical Specialists of Northeast Florida, PLLC 665 SR 207, Ste 102, St. Augustine, FL 32084 1680 Osceola Elementary Blvd., Ste. A, St. Augustine, FL 32084

2/4/201109/25/12

SSG SSG

St. Johns Avanti Wellness Center 3574 US Hwy 1 South, St. Augustine, FL 32086 2/11/2011

SSG

St. Johns Medi MD 167 Palencia Village Drive, Ste 101, St. Augustine, FL 8/16/11 SSG


4/07/2015


Method of Approval

32095 St. Johns Dr. James R. Conner PA 1851 Old Moultrie Road, Ste. A, St. Augustine, FL 32084 904-824-8088 06/15/12 SSG St. Johns Pediatrics in North Florida 109 Whitehall Drive, Ste. 117, St. Augustine, FL 32086 286-446-8333 06/22/12 SSG St. Johns Global Health Records Inc. 1851 Old Moultrie Road, St. Augustine, FL 32086 904-794-7830 06/22/12 SSG St. Lucie St. Lucie County Health Department 714 Ave C., Ft. Pierce, FL 34954 561-873-4924 CHD St. Lucie Florida Medical Center 10616 South Federal Highway, Pt. St. Lucie, FL 32452 06/08/11 SSG St. Lucie Andrelica, 10616 South Federal Highway, Port St. Lucie, FL 34952 8/16/11 SSG St. Lucie American Care of South Florida, Inc. 1404 S. 28th Street, Ft. Pierce, FL 34947 12/13/13 SSG St. Lucie M Care Medical Center, Inc. 850 South 21st Street, Ste. B, Ft. Pierce, FL 34940 03/17/14 SSG St. Lucie Humayun Shareef, MDPA 601 North 7th Street, Ft. Pierce, FL 34950

320-322 Northwest Bethany Drive, Pt. St. Lucie, FL 34953 2401 Frist Blvd., Ste. 1, Ft. Pierce, FL 34950

06/04/1407/25/14 07/25/14

SSG SSG SSG

St. Lucie Vital Chiropractic Wellness DBA Vital Wellness Center

2624 South Federal Highway Fort Pierce, Florida 34982 12/04/14 SSG

St. Lucie Internal Medicine Consultants of St Lucie County

2401 Frist Boulevard, Suite 1 Fort Pierce, Florida 34950

2/12/15 SSG

Sumter Sumter County Health Department 415 E. Noble Ave., P.O. Box 98, Bushnell, FL 33513 104 Rutland St., Wildwood, FL 34785

352-793-2701

CHD

Sumter Lazarus Free Medical Clinic (previously Catholic Charities of Central Florida, Inc)

210 Wonders St, Wildwood, FL 34785 352-748-4567 4/16/08 VHCPP

Sumter Project Health, Inc 1389 S US Hwy 301, Sumterville, FL 33585 11/10/201

SSG

Sumter The Clark Clinic, Inc. 212 S Florida Street, Bushnell, FL 33513 352-793-2441 9/19/11 SSG Sumter Rural Medical Associates, Inc. DBA Wildwood

Medical Center 411 Webster Street, Wildwood, FL 34785 08/24/13 SSG

Sumter Florida Medical Associates, LLC 1950 Laurel Manor Dr., Bldg. 210, The Villages, FL 32162 08/20/13 SSG Sumter Children’s Medical Group 1950 Laurel Manor Dr., Bldg. 240, The Villages, FL 32162 08/26/13 SSG Sumter Premier Medical Associates 411 N. West Street, Bushnell, FL 33513 03/11/14 SSG Sumter LifeStream Behavioral Center 119 North Market Street, Bushnell, FL 33513

340 Heald Way, Ste. 208, The Villages, FL 32162 09/25/14

10/01/14SSG SSG

Suwannee Suwannee County Health Department P.O. Drawer 6030, Live Oak, FL 32064 904-362-2708 CHD Suwannee Three Rivers Medical Center 208 Northwest Suwannee Ave, Branford, FL 32008 11/03/14 SSG Taylor Taylor County Health Department 1215 Peacock Street, Perry, FL 32347-2117 850-584-5087 CHD Taylor Taylor County Health Department and Veterans

Affairs Outreach Clinic 1215 N Peacock Ave, Perry, FL 32347 12/8/201

0SSG

Taylor Premier Medical Pediatric Clinic 315 E. Ash Street, Perry, FL 32347 850-584-3278 9/8/11 SSG Union Union County Health Department 495 E. Main St., Lake Butler, FL 32054-1731 904-496-3211 CHD


4/07/2015


Method of Approval

Union Marvin W. Johnson, MD 850 E Main St, Lake Butler, FL 32054 10/15/2010

SSG

Union Lake Butler Hospital 850 Main St, Lake Butler, FL 32054 11/4/2010

SSG

Union Dynamic Health Centers, Inc. 155 Southeast 6th Place, Lake Butler, FL 32054 04/25/14 SSG Volusia NE Florida Health Services

- Pierson Medical Center 114 N. Volusia Avenue, Pierson, FL 32180

386-749-9449

s. 330

Volusia

Volusia County Health Department - Care Center

501 S. Clyde Morris Blvd. Daytona Beach, FL 32114-3997 121 S. Palmetto Ave., Daytona Bch, FL 32114 1330 S. Woodland Blvd., Deland, FL 32720 717 W. Canal St., New Smyrna Bch, FL 32168 100 Wolf Pack Run, Deltona, FL 32725

386-947-3414 386-255-0019 386-822-6215 386-424-2066 386-789-8401

CHD

Volusia Good Samaritan Clinic 312 W New York Ave, Deland, FL 32720 386-738-6990 12/08 VHCPP Volusia Central Florida Primary Physicians, LLC 1515 Saxon Blvd, Ste 301, Deltona, FL 32725 4/13/201

1SSG

Volusia Florida Family Healthcare 80 Spring Vista Drive, Suite 100 386-320-0371 9/28/11 SSG Volusia Family Medicine & Holistic Center, Inc. 887 Deltona Blvd., Deltona, FL 32725 06/25/14 SSG Volusia Island Doctors of New Smyrna Beach Medical

Center, LLC 406 Palmetto Street Ste., A&B New Smyrna Beach, FL 32168

11/19/14 SSG

Wakulla Wakulla County Health Department 3093 Crawfordville Hgwy, Crawfordville, FL 32327 850-926-3591 CHD Walton Walton County Health Department

- Paxton Clinic, Paxton 493 N. 9th St., DeFuniak Spgs, FL 32433-9401 21872 US Hwy 331North, Paxton, FL 32538

850-892-8027 850-892-8015

CHD

Walton Community Health Center – Walton 479 E. Highway 20, Freeport, FL 32439 850-880-6568 10/24/12 SSG Washington Washington County Health Department 338 South Boulevard, Chipley, FL 32428-2208 850-638-6240 CHD Community Corrections Division 4/6/97 DOC Montgomery Correctional Center 4/6/97 DOC Northeast Florida State Hospital 1/30/95 Mental

Institution NOTE: The County Health Departments specifically listed above are currently employing limited license holders. Pursuant to Code 64B8-2.001(4), Florida Administrative Code, the Board defines the “areas of critical needs,” “areas of critical medical need”, and “medically underserved areas” as used in Sections 458.315(1) and 458.317(1)(d), F.S., respectively, shall include but not be limited to the following: Areas designated by the Department of Health and Human Services as health professional shortage areas; State mental institutions; State institutions for the mentally retarded; or State prison

ALL State Department of Health facilities and County Health Departments are approved to employ limited license & temporary certificate holders.


4/07/2015


Method of Approval

Revised 09/27/05

approved facilities 4-07-15 · 6830 pines blvd, pembroke pines, fl 33024 1609 e vine st, kissimmee,...

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