?tv? STATE OF FL Final Order No. non-9345320 Dan: 3 -30 BOARD OF OSTEOPA Dcpartniunt of Health Department of Health, Petitioner, vs. DOH CASE NO.: 95-17768 CASE NO.: 96-05071 CASE No.2 96-13114 LICENSE NO.: 08 0004773 GARY LEE MARDER, D.O., Respondent. NA VIN THIS MATTER came before the Board of Osteopathic Medicine (hereinafter referred to as the ?Board?) pursuant to Section Florida Statutes, on February 20, 1998, in Ft. Lauderdale, Florida, for a determination of whether to accept the proposed consent agreement, a copy of which is attached and incorporated herein by reference, entered into between the parties in the above-styled case. The Petitioner was represented by Larry G. McPherson, Jr., Esquire. Respondent and Matthew Boller, Esq., his attorney were both present at the meeting. Upon consideration of the Administrative Complaints and the proposed consent agreement in this matter, and being otherwise fu iy advised in the premises, it is hereby ORDERED AND ADJUDGED: 1. The proposed consent agreement is hereby approved, adopted and incorporated herein by reference. 2. The Respondent will adhere to and abide by all of the terms and conditions of Angela Hall, AGENCY CLERIEL I i . the consent agreement. 3. This Order shall be placed in and become a part of Respondent?s official records and shall become effective upon ?ling with the Clerk of the Department of Health. DONE and ORDERED this of March, 1998. BOARD OF OSTEOPATHIC MEDICINE 9? me} Joel? . Rose, D.O. CH ERT I I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by United State Mail to Matthew H. Boller, Esq.,.Attorney for Respondent, Stephens Klein 8. McNicho as, PA., 515 N. Flagler Drive, Suite 1600, West Palm Beach, Florida 33401 and by interof?ce mail to Larry G. McPherson, Jr., Department of Health, 2727 Mahan Drive, Palmer Building, Tallahassee, FL 32308-5403 this day of March, 1998. AMENDED CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Order has been provided by certi?ed mail to Gary Lee Marder, 13.0., 8483 South Federal Hwy, Suite 19, Ft. Pierce, FL 34900, to Matthew H. Boller, Esquire, Stephens Klein McNicholas, P.A., 515 N. Flagler Drive, Suite 1600, West Palm Beach, FL 33401, and interof?ce delivery to Larry McPherson, Jr. Chief Attorney, 2727 Mahan Drive, Tallahassee, Florida 32308-5403, at or before 5:00 this day of 1998. 11:85 15616592893 PAGE 83 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION DEPARTIVIEDLITL or HEALTH, Petitioner, v. AHCA CASE NOS. 95-17768 96-05071 96-13114 GARY LEE MARDER, D.0., Respondent. Gary Lee Marder, D.O., referred to as the "Respondent," and the Department of Health, through and by the Agency for Health Care Administration, referred to as "Agency," stipulate and agree to the following Agreement and to the entry of a Final Order of the Board of Osteopathic Medicine, referred to as "Board," incorporating the Stipulated Facts and Stipulated Disposition in this matter. 1. At all times material hereto, Respondent was a licensed osteopathic physician in the State of Florida having been issued license number OS 0004773. 2- Respondent was charged by Administrative Complaints ?led by the Agency and properly served upon Respondent with violations of Chapter 459, Florida Statutes, and the rules enacted pursuant thereto. A true and correct copy of the Administrative Complaints is attached 1 31/22/1998 11:85 156165921393 PAGE 84 hereto as Exhibit A. 3. Respondent neither admits nor denies the allegations of fact contained in the Administrative Complaint. 1. Respondent adtnits that, in his capacity as a licensed osteopathic physician, he is subject to the provisions of Chapters 455 and 459, Florida Statutes, and the jurisdiction of the Agency and the Board. 2. Respondent admits that the facts set forth in the Administrative Complaint, if proven, would constitute violations of Chapter 459, Florida Statutes, as alleged in the Administrative Complaint. 3. Respondent admits that the stipulated disposition in this case is fair, appropriate and acceptable to Respondent. l. Respondent shall not in the future violate Chapters 455, 459 and 893, Florida Statutes, or the rules promulgated pursuant thereto. Prior to his appearance before the Board, Respondent shall read Chapters 455, 459 and 893 and the Rules of the Board of Osteopathic Medicine, at Section 59W, Florida Administrative Code. I 2. EIISE, _The Board shall impose an administrative ?ne in the amount of $2,500.00 (two thousand ?ve hundred) against the Respondent. The ?ne shall be paid by the Respondent to the Board of Osteopathic Medicine within days of its imposition by Final Order of the Board. THE RESPONDENT ACICNOWLEDGES THAT THE TDIELY PAYIVIENT OF THE FINE IS HIS LEGAL OBLIGATION AND RESPONSIBILITY AND THE 2 81.122/1998 11: B5 15616592893 PAGE 85 RESPONDENT AGREES TO cease MEDICINE IF rasmn-: IS NOT PAID AS AGREED TO IN THIS AGREEMENT, SPECIFICALLY: IF THE RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION THAT FULL AMOUNT OF THE FINE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN 90 DAYS OF THE FILING OF THE FINAL ORDER OF THE BOARD ADOPTING THIS CONSENT AGREEMENT, THE RESPONDENT AGREES TO CEASE PRACTICE UNTIL SUCH WRITTEN CONFIRMATION IS RECEIVED BY THE RESPONDENT FROM THE BOARD. (SEE EXHIBIT OF THIS CONSENT AGREEMENT FOR BOARD ADDRESS AND STANDARD TERMS). 3. . Within one (1) year of the ?ling of the Final Order incorporating the terms of this Agreement, Respondent shall complete twenty (20) hours of continuing medical education in the area of medical-record keeping. The Board confers authority on the Chairman of the Board to approve or disapprove said continuing education hours. In addition, Respondent shall submit documentation in the form of certi?ed copies of the receipts, vouchers, certi?cates, or other papers, such as physician's recognition awards, documenting completion of these medical education courses within one (1) year of the entry of the Final Order These hours shall be in addition to those hours required for renewal of licensure. Unless otherwise approved by the Board, said continuing medical education courses shall consist of a formal, live lecture format 4. . Within one (1) Of the ?ling Of the 3 11:85 15515592893 PAGE BE Final Order incorporating the terms of this Agreement, Respondent shall complete ?ve (5) hours of continuing medical education in the area of risk management in medicine. The Board confers authority on the Chairman of the Board to approve or disapprove said continuing education hours. In addition, Respondent shall submit documentation in the form of certi?ed copies of the receipts, vouchers, certificates, or other papers, such as physician's recognition awards, documenting completion of these medical education courses within one (1) year of the entry of the Final Order These hours shall be in addition to those hours required for renewal of licensure. Unless otherwise approved by the Board, said continuing medical education courses shall consist of a formal, live lecture format. 5. . next twelv? months following the filing date 'u4_ "6 a of a Final Order in this case, Respondent shall perform hours of community service at a rate of ten hours per every three months. Community service shall consist of the delivery of medical services directly to patients, without fee or cost to the patient, for the good of the people of the state of Florida Such community service shall be performed outside the Respondent's regular practice ?Respondent shall submit a written plan for performance and completion of the community service to the Board for approval prior to performance of said community service. Affidavits the completion of community service requirements shall be filed with the Board quarterly. 6. I An independent, certi?ed risk _manager will review Respondent's current practice prior to the Board's consideration of this 4 11:85 15515592893 PAGE 87 Agreement. Speci?cally, this independent consultant shall review each type of procedure performed by Respondent (including Respondents system for con?rming diagnoses), the training and duties of Respondent's medical staff, and Respondent's method of record keeping. This consultant will prepare a report addressing Respondent's practice. This report will include suggested improvements of the quality assurance of Respondent?-s practice. Respondent will submit this report, as well as documentation that demonstrates his compliance with the suggestions enumerated in the report, to the Board within four (4) months of the ?ling date a Final Order in this case. 7. It is expressly understood that this Agreement is subject to the approval of the Board and the Agency- In this regard the foregoing paragraphs (and only the foregoing paragraphs) shall have no force and effect unless a Order is entered incorporating the terms of this Agreement, by the Board. 8. Respondent shall appear before the Board at the meeting of the Board where this Agreement is considered. Respondent, in conjunction with the consideration of this Agreement by the Board, shall respond to questions under oath ?'om the Board, Board Staff or Agency Staff. Respondent shall be prepared to explain the circumstances involved in this matter and what measures have been taken to prevent a reoccurrence. However, Respondent shall offer no evidence, testimony or argument that disputes or contravenes any stipulated fact or conclusion of law. 9. Should this Agreement be rejected, no statement made in furtherance of this Agreement by the Respondent may be used as direct evidence against the Respondent in any proceeding; however, such statements may be used by the Petitioner for impeachrnent purposes. 10. Respondent and the Agency frilly understand that this joint Agreement and 5 81/22/1998 11:85 15818592693 PAGE subsequent Final Order incorporating same will in no way preclude additional proceedings by the Board andfor the Agency against the Respondent for acts or omissions not speci?cally set forth in the Administrative Complaint attached as Exhibit A herein. 11. Upon the Board's adoption of this Agreement, Respondent expressly waives all further procedural steps, and expressly waives all rights to seek judicial review of or to otherwise challenge or contest the validity of the Agreement and the Final Order of the Board incorporating said Agreement. 12. Upon the Board's adoption of this Agreement, the parties hereby agree that each party will bear his own a1tomey's fees and costs resulting from prosecution or defense of this matter. Respondent waives the right to seek any attorney's fees or costs from the Agency in connection with this matter. I 13. This Agreement is executed by the Respondent for the purpose of avoiding ?irther administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all investigative ?le materials concerning Respondent prior to or in conjunction with consideration of the Agreement. Furthermore, should this joint Agreement not be accepted by the Board, it is agreed that presentation to and consideration of this Agreement and other documents and matters by the Board shall not unfairly or illegally prejudice the Board or any of its members from further participation, consideration or resolution of these proceedings. 81/22/1998 11:85 15515592893 PAGE 89 SIGNED mi day of 199$ Bcforc me. QQ .%ox identity is known to me by (type of identi?cation) and who, under oath, acknowledges that his/her signature appeaxs zlbove. Sworn GrCommission Expires: HV I thjs?2?_3day 1998. - James T. Howell, M.D., By: Chief Attorney Medical Section STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION BOARD OF OSTEOPATHIC MEDICINE AGENCY FOR HEALTH CARE ADMINISTRATION, PETITIONER, i v. i CASE NO. 95-17768 GARY LEE MARDER, D.O. i RESPONDENT. i ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Agency for Health Care Administration, hereinafter referred to as ?Petitioner,? and files this Administrative Complaint before the Board of Osteopathic Medicine against Gary L. Marder, D.O., hereinafter referred to as ?Respondent," and alleges: 1. Petitioner is the state agency charged with regulating the practice of medicine pursuant to Section 2042, Florida Statutes; Chapter 455, Florida Statutes, and Chapter 459, Florida Statutes. 2. Respondent is and has been at all times material hereto a licensed osteopathic physician in the state of Florida, having been issued license number OS 0004773. Respondent?s last known address is 8483 South Federal Highway, #19, Ft. Pierce, FL 34900. 3. On or about November 8, 1995, Patient M.M. presented to Respondent for the removal of three (3) moles located on the patient?s face. Respondent proceeded to destroy ten (10) lesions from Patient abdomen and three (3) lesions from Patient face by use of cauterization. The three (3) moles were not removed. Patient M.M. was told by Respondent that it would take three (3) additional office visits to remove the moles. 4. Respondent billed Patient insurance company for the destruction of ?fteen (15) facial lesions and ?fteen (15) other lesions when in fact only thirteen (13) removals were performed. 5. Respondent?s medical records of Patient M.M. fail to reflect a comprehensive history and physical in that the only information recorded pertains to the removal of lesions. Respondent fails to document a comprehensive history and physical ?ndings that would normally be documented by any reasonably prudent physician in the evaluation of a new patient. 6. Respondent failed to document the patient?s consent for the removal of any lesions. The patient presented for the removal of three (3) moles, none of which were removed. However, Respondent removed thirteen (13) lesions with no documentation of permission obtained from Patient M.M. 7. Respondent failed to adequately indicate in Patient medical records the size or location of the lesions removed. 8. Respondent charged a combined total of one thousand two hundred and twenty dollars for the removal of thirteen (13) lesions using a variety of billing codes. Respondent charged Patient M.M. the amount of one hundred and forty dollars ($140.00) for the initial evaluation. An initial evaluation, as billed by Respondent, requires a comprehensive history, comprehensive evaluation, and medical decision making of high complexity. 9. An Agency expert reviewed the case and opined that Respondent?s billing for the initial evaluation was inappropriate and not supported by an initial history and physical comprehensive enough to charge Patient M.M. the amount of one hundred and forty dollars that there is no documentation in Patient medical records that permission was obtained or that the patient was informed of the need for the removal/destruction of the lesions removed, and that there is no documentation in Patient medical records regarding the exact location, size, or appearance ofthe lesions removed. COUNT ONE 10. Petitioner realleges and incorporates paragraphs one (1) through eight (8), as if fully set forth herein this Count One. i ll. Respondent is guilty of making or filing a report which the licens-ee knows to be false in that Respondent submitted a false and fraudulent claim to Patient insurance company for medical services not rendered in that Respondent billed Patient insurance company for the destruction ofthirty (30) lesions when in fact he only removed thirteen (13). 12. Based on the foregoing, Respondent violated Section 459.015 Florida Statutes, by making or filing a report which the licensee knows to be false. COUNT TWO 13. Petitioner realleges and incorporates paragraphs one (1) through eight (8), and ten (10) as if fully set forth herein this Count Two. 14. Respondent is guilty of failing to keep written medical records justifying the course of treatment of Patient M.M. in that the medical records of Patient M.M fail to document the exact location size, or appearance of the lesions removed. 15. Based on the foregoing, Respondent violated Section 459.015 Florida Statutes, by failing to keep medical recordsjustifying the course oftreatment ofthe patient. COUNT THREE 16. Petitioner realleges and incorporates paragraphs one (1) through eight (8), ten (10), and thirteen (13) as if fully set forth herein this Count Three. 17. Respondent is guilty of exercising in?uence on Patient M.M. in such a manner as to exploit her for ?nancial gain in that the" Respondent charged Patient M.M. for a comprehensive history, comprehensive examination, and medical decision making of high complexity, yet failed to provide these services. 18. Based on the foregoing, Respondent violated Section 459.015 Florida Statutes, by exercising influence on the patient ofclient in such a manner as to exploit the patient or client for the ?nancial gain ofthe licensee. WHEREFORE, the Petitioner respectfully requests the Board of Osteopathic Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension ofthe Respondent?s license, restriction ofthe Respondent's practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, the assessment of costs related to the investigation and prosecution of this case, other than costs associated with an attorney?s time, as provided for in Section Florida Statutes, and/or any other relief that the Board de-ems appropriate. SIGNED this xi day of M, ,1997. Douglas M. Cook, Director Lany G. McPherson, Jr. Chief Medical Attorney I AGENCYFOR COUNSEL FOR HEALTH CARE ADMINISTRATION DEPUTY CLERK Larry G. McPherson, Jr. CERK Chief Medical Attorney bm-E f- (P- Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 32317-4229 Florida Bar 788643 PCP: April 30, 1997 PCP Members: James Barker, D.O., and Joel Rose, D.O. OF FLORIDA AGENCY FOR HEALTH CARE BOARD OF OSTEOPATHIC MEDICINE AGENCY FOR HEALTH CARE ADMINISTRATION, PETITIONER, vs. CASE NO. 96-05071 GARY LEE MARDER, D.O. RESPONDENT. I ADMTNISTRATIVECOMPLAINT COMES NOW the Petitioner, Agency for Health Care Administration, hereinafter referred to as "Petitioner," and ?les this Administrative Complaint before the Board of Osteopathic Medicine against Gary Lee Marder, D.O., hereinafter referred to as "Respondent," and alleges: 1. Petitioner is the state agency charged with regulating the practice Of osteopathic medicine pursuant to Section 20.42, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 459, Florida Statutes. 2. Respondent is and has been at all times material hereto a licensed osteopathic physician in the State of Florida, having been issued license number 0004773. Respondent's last known address is 8483 S. Federal Hwy., Suite 19, Ft. Pierce, FL, 34900. 3. On or about March 1, 1996, Patient S.W. presented to the Subject with a twenty?five (25) year history of a chronically swollen and greenish in color thumb. 4. At the visit Patient S.W. had a complete examination of her sun-exposed skin and was found to have a lesion of her nose and a small epidermoid of the back. A biopsy was performed from the nose and an incision and drainage was performed on the back lesion. 1 5. Scaling of the ears was treated with betamethasone valerate cream. Patient S.W. was charged twenty?one dollars ($21 .00) for the cream at the Respondent's office. 6. Patient S.W. was required to pay for medication dispensed by the Subject. 7. When the biopsy was reported as being a basal cell carcinoma, Patient S.W. presented for a second opinion by a plastic surgeon who was unable to locate a surgical scar from the incision and drainage procedure after only four (4) weeks from the date the Respondent reported performing the surgery. Had Respondent performed the surgery, a scar would have been detectable in such a short period of time. The plastic surgeon agreed with the diagnosis of the basal cell carcinoma and performed surgery. 8. The insurance records from the visit with the Respondent show that Patient S.W. . was charged five hundred and forty dollars ($540.00) for two (2) surgeries, although the plastic surgeon was unable to locate a scar from the incision and drainage procedure. 9. An Agency expert reviewed this case and determined that the clinical office records and insurance records do not justify the evaluation and management code charged to the insurance company by the Subject in that the initial consultation fee is excessive and fraudulent. According to the expert, the code charged to the insurance company and to the patient would involve comprehensive history, comprehensive evaluation, and a medical decision making of high complexity that involves the physician spending approximately sixty (60) minutes face to face with the patient. According to the medical records, a more appropriate code would have been one that required less comprehensive history, evaluation, and less time 10. A reasonably prudent physician in a reasonably similar situation would have used a code that involved less comprehensive history, evaluation, and less time of physician/patient contact, and would have charged the insurance company and patient accordingly. 1. Based on the foregoing, Respondent violated Section 459.015 Florida Statutes, and is guilty of exercising in?uence on the patient or client in such a manner as to exploit the patient or client for ?nancial gain of the licensee or of a third party which shall include, but not be lifnited to, the promotion or sale of services, goods, appliances, or drugs. WI-IEREFORE, the Petitioner respectfully requests the Board of Osteopathic Medicine enter an Order imposing one or more of the following penalties: permanent revocation or suspension of the Respondent's license, restriction of the Respondent's practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, the assessment of costs related to the investigation and prosecution of this case, other than costs associated with an attorney's time, as provided for in Section Florida Statutes, andfor any other relief that the Board deems appropriate. SIGNED this ?fl day of ?g/4 ,t997. Douglas M. Cook, Dir La}? (3. Mcphergeff, Jr. Chief Medical Attorney AGENCY FOR HEALTH CARE ADMINISTRATION DEPUTY CLERK - .. MU . DATE 5" 50 ?i '7 COUNSEL FOR AGENCY: Larry G. McPherson,Jr. ChiefMedical Attorney Agency for Health Care Administration Box 14229 Tallahassee, Florida 32317-4229 Florida Bar #788643 FP\l(t PCP: 30, mm ?3C>&l Flose ,1 (Q. STATE OF FLORIDA DEPARTMENT o1= HEALTH DEPARTMENT or HEALTH, i v. i CASE No. 96-13114 GARY LEE MARDER, D.O., i RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Department of Health, hereinafter referred to as ?Petitioner,? and ?les this Administrative Complaint before the Board of Osteopathic Medicine against Gary Lee Marder, D.O., hereinafter referred to ?Respondent,? and alleges: 1. Effective July 1, 1997, Petitioner is the state agency charged with regulating the practice of osteopathic medicine pursuant to Section 20.43, ?Florida Statutes (Supp. 1996); Chapter 455, Florida Statutes, and Chapter 459, Florida Statutes. Pursuant to the provisions of Section Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils, or boards, as appropriate. 2. 'Respondent'is and has been at times-material hereto a licensed osteopathic physician in the state of Florida, having been issued license number OS 0004773. Respondent?s last known address is 8480 S. Federal Highway, Suite 19, Ft. Pierce, Florida 34900. 3. On or about June 9, 1995, Patient M.J. presented to Respondent at which time he was noted to have a probable squamous cell carcinoma on the right side of his neck. A biopsy was taken. Ten (10) keratoses were destroyed by cautery. In addition, Respondent noted tinea manus, a fungus infection of the hand. A possible squamous cell carcinoma of the left outer area was noted as was a on Patient back. Respondent ordered the performance of several blood tests. 4. On or about June 9, I995, Respondent billed Patient insurance company two hundred and ?fty dollars ($250.00) for a biopsy of the soft tissue of the right neck, although the patholoigy report describes a 0.6 0.4 cm. skin shave. 5. Laboratory tests conducted on June 9, 1995 were unnecessary and inappropriate in that the medical record contains no clinical indication for the tests. 6. On or about June 23, 1995, Patient M.J. -retumed to Respondent at which time the carcinoma on the right side of Patient neck was removed. Respondent also conducted additional blood tests. 7. Respondent billed Patient insurance company one thousand dollars ($1000.00) for the excision of a malignancy over four (4) centimeters in diameter. However, the pathology report describes a 1.7 -1.5 0.6 centimeter specimen. Respondent also billed one thousand ?ve hundred dollars for an adjacent tissue transfer which would normally be supported by a layered closure, absorbable ?sutures, and/or the removal of redundant tissue. Medical records of Patient M.J. contain no documentation of a layered closure, absorbable sutures, or the removal of redundant tissue. 8. On or about July 14, 1995, Respondent removed a carcinoma of the left outer area on Patient M.J. I.n addition, eight (8) keratoses were destroyed. 9. I Respondent failed to note the size of the carcinoma of the left outer eye. . 10. Respondent's office notes for Patient M.J. fail to adequately document a complete physical for Patient M.J. in that the physical examination of the skin was limited to the face, neck, back, and hands. I 11. Respondent failed to properly document the carcinoma of the left outer area in that the carcinoma was not adequately described, photographed, or biopsied. 12. Respondent failed to adequately document in Patient medical records the size, location, or description of the ten (10) keratoses destroyed on or about June 9, 1995, and the eight (8) keratoses destroyed on or about July 14, 1995. 13. On or about June 23, 1995, Respondent billed Patient insurance company five hundred and ?fty dollars ($550.00) for a special operating room. This charge is not supported by Respondent?s medical ?records for Patient M.J. Additionally, Respondent improperly billed Patient insurance company by charging four hundred and ?fty dollars ($450.00) for a single surgical tray. 14. Respondent's charges for the treatment of Patient are excessive and not supported by the patient?s medical record. WHEREFORE, the Petitioner respectfully requests the Board of Osteopathic Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of the Respondent?s license, restriction of the Respondent?s practice, ?imposition of an administrative ?ne, issuance of a reprimand, placement "of the Respondent on probation, the . . - assessment of costs related to the investigation and prosecution of this case, other than costs associated with an attorney?s time, as provided for in Section Florida Statutes, and/or any other relief that the Board deems appropriate. 2 I I . SIGNED this 2.3 dayof <2Z&g? 1997. games T. Howell, M.D., Secretary Larry G. McPherson, Jr. Chief Medical Attorney COUNSEL FOR DEPARTIVEENT: Larry G. McPherson, Jr. Chief Medical Attorney Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 32317-4229 Florida Bar 765996 FP/kt PCP: July 24, 1997 . PCP Members: Gerardo Perez, D.O., and_ Robert Hand, D.O. FILED LTH DEPARTMENT OF TY CL i?wdw