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Mark Rabinowitz Application PackageMIAMI BEACH Rabinowitz Last Name 1550 NE Quayside Terrace Home Address 7862886674 3055388835 Cellular Telephone Work Telephone Miami Beach Community Health Center Business Name 71 0 Alton Road Business Address Mark First Name Miami City 7862886674 Home Telephone Physician Occupation Miami Beach City BOARD AND COMMITTEE APPLICATION L Middle Initial Florida 33138 State Zip Code mrabinowitz@mbchc.com Email address Florida 33139 State Zip Code Please list your preferences in order of ranking: [1) first choice, [2) second choice, and [3) third choice. Please note that only three (3) choices will be observed by the Office of the City Clerk. Affordable Housing Advisory Health Advisory Committee Normandy Shores Local Government Committee Neighborhood Improvement District X Advisory Council Animal Welfare Committee Health Facilities Authority Board Parks and Recreational Facilities X Board Art in Public Places Committee Hispanic Affairs Committee Personnel Board Audit Committee Historic Preservation Board * Planning Board Black Affairs Advisory Committee Housinq Authority Police/Citizens Relations Committee Board of Adjustment Human Rights Committee Production Industry Council Budget Advisory Committee LGBTQ Advisory Committee Program for Public Information Committee Committee for Quality Education in Marine & Waterfront Protection Senior Affairs Committee Miami Beach Authority Committee on the Homeless Mayor's 41st Street Committee Sustainability Committee Convention Center Advisory Board Mayor's General Obligation Bond Transportation , Parking , and Bicycle- Oversight Committee Pedestrian Facilities Committee Cultural Arts Council Mayor's Panel on Ocean Drive Visitor and Convention Authority Desiqn Review Board Miami Beach Commission for Women Youth Commission Disability Access Committee Next Generation Council 1. Health Advisory Committee 2 . Health Facilities Authority Board 3 . Professional License Physician ME 36822 Type of Professional License Florida License Number 07/01/1980 01/31/2022 State of Issuance License Issuance Date License Expiration Date Note: If you are seeking appointment to a professional seat (e .g . attorney , architect , etc.), you must attach a copy of your current! effective corres ondin rofessional license . Page 1 of 6 F:\C LER \$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER \BOARD A ND COMMITTEE APPLICATION .docx Updated: June 2020 AFFILIATION WITH THE CITY OF MIAMI BEACH Pursuant to City Code section 2-22(4) a, b, and c: Members of Agencies , Boards , and Committees shall be affiliated with the City . This requirement shall be fulfilled in the following ways : a. Resident of the City for a minimum of six months : Yes 0 or QgNo • I am a resident of: South Beach 0 Middle Beach 0 North Beach 0 Or b. Demonstrates an ownershieJ!!terest (for a minimum of six months) in a business established in the City (for a minimum of six months): Yes 0 or l.l..INo "Ownership Interest" shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business " shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. Or c . Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of the business ttiat is physically located in Miami Beach (for a minimum of six months): Yes [2S] or DNo Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by a 417th vote of the Mayor and City Commission . NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation requirements of sections 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they have met either (or both} of said affiliation requirements. The original affidavit shall be filed with the Office of the City Clerk prior to being sworn in as a member. • I am applying for an appointment because I have special abilities , knowledge, and experience . Please list below: I am the CEO and CMO of Miami Beach Community Health Center. I am not certain of the veracity of the statement, but a City of Miami Beach staffer told me that the HAC Bylaws requires that one board seat be committed to the Miami Beach Community Health Center CEO. I was also told that as the Chair of the HAC, I am required to sit on the HFA Board . Page 2 of6 F:ICLERI$ALLIBOARD AND COMMITTIES DATABASEICHECKLIST MASTER \BOARD AND COMMITTEE APPLICATION .docx Updated: June 2020 • Are you .a registered active lobbyist with the City of Miami Beach? Yes 0 or No (KI • Have you ever been convicted of a felony? Yes 0 or No [XJ If yes , please explain in detail : • Do you currently have a violation(s) of City of Miami Beach Code? Yes 0 or No lXl If yes , please explain in detail : • Do you currently owe the City of Miami Beach money? Yes 0 or No !Xl If yes , please explain in detail : • Are you currently serving on any City Board or Committee? Yes IZJ or No 0 If yes , which Board/Committee? Health Advisory Committee and and Health Facilities Authority Board • In what organization(s) in the City of Miami Beach do you currently hold membership? None Name Position Name Position • List the address of all properties owned or in which you have an interest within the City of Miami Beach : None • Are you now employed by the City of Miami Beach? Yes 0 or No IXJ If so , which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spouse 0, child 0 brother D or sister 0 who is employed by the City of Miami Beach? Yes Oor No lKl If "Yes," identify person(s) and department(s): -------------------------- * Note: If applying for the At-Large position of the Historic Preservation Board, please answer the below questions : • Have you ever resided in one of the City's Historic Districts for at least one year? Yes D or NoD If you answered "Yes ," please indicate : From : Address Dates From : Address Dates Page 3 of6 F:\C LER \$ALLIBOARD AND COMMITTIES DATABASE \CHECKLIST MASTER \BOARD AND COMMITTEE APPLICATION .docx Updated: June 2020 To To NOTE : IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO: o Prohibition from directly or indirectly lobbying City personnel. (Miami Beach City Code Section 2-459) o Prohibition from contracting with the City. (Miami-Dade County Code Section 2-11 .1) o Prohibition from lobbying before the Board/Committee you have served on for period of one year after leaving office . (Miami Beach City Code Section 2-26) o Requirement to disclose certain financial interests and gifts. (Miami-Dade County Code section 2-11 .1) o Sunshine Law -Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chapter 286 of the Florida Statutes . These statutes establish a basic right of access to most meetings of Boards, Commissions , and other governing bodies of state and local governmental agencies or authorities. o Voting conflict-Form 8B is for use by any person serving at the county, city, or other local level of government on an appointed or elected Board, Council, Commission , Authority , or Committee . It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112 .3143 , Florida Statutes . I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND'fiR s;rATE LAWS A ~ STATUTES ACCORDINGLY." ~ jt_P.J(ltA.-{)l..U l 11/17/2020 Mark Rabinowitz Applicant's Signature Date Name of Applicant (PLEASE PRINT) Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee Qf I have answered all questions fully. Qf I have attached additional sheets, if necessary , to provide required information . Qf I have attached a current resume , photograph, and a copy of any applicable professional license. Qf I have completed and attached the Board & Committee Financial Acknowledgement Statement. Qf I have completed and attached the Diversity Statistics Report . Qf Submit complete application package . Via Email : BC@miamibeachfl .gov Via U.S . Mail or in Person : City of Miami Beach Office of the City Clerk I Board and Committee Section 1700 Convention Center Drive , 1st Floor Miami Beach, FL 33139 If you have any questions, please contact the Office of the City Clerk via email : BC@miamibeachfl.gov or telephone : 305 .673.7411 . Note: Florida Statutes §119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public records. If your home address , telephone numbers, and/or photograph are exempt from disclosure and you do not wish your home address, telephone numbers , and/or photograph to be made public, please : 1) Use your office or other address for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a photograph. Page 4 of6 F:\CLERI$ALLIBOARD AND COMMITTIES DATABASE \CHECKLIST MASTERIBOARD AND COMMITTEE APPLICATION .docx Updated : June 2020 MIAMI BEACH City of Miami Beach 1700 Convention Cente r Drive M iam i Beach , Flor ida 33139 www.miamibeachfl .gov O FF ICE OF THE CITY CLERK Em ail : BC@miamibeachfl.gov Telephone : 305 .673.7 411 BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami- Dade County Financial Disclosure Code Provision Code Section 2-11.1 (i) (2) Rabinowitz Mark L Last Name First Name Middle Initial 1 understand that no later than July 1. of each year all members of Boards and Committees of the City of Miami Beach, including those of a purely advisory nature, are required to comply with Miami-Dade County Financial Disclosure Requirements. One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year: 1. A "Source of Income Statement ;" or 2. A "Statement of Financial Interests (Form 1)1;" or 3. A Copy of your latest Federal Income Tax Return. Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine of no more than $ 0, 60 days in jail, or both . · {'/'wJ' h ~'4___;_1~+--/UJ ____ _ Date 1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112 .3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 5 of6 F:ICLERI$ALLIBOARD AND COMMITTIES DATABASEIC HECKLIST MASTER\BOARD AND COMMITTEE APPLICATION .docx Updated: June 2020 MIAMI BEACH City of Miami Beach 1700 Convention Center Drive M iami Beach, Florida 331 39 www .miamibeachfl.gov OFFICE OF THE CITY CLERK Email : BC@miamibeachfl.gov Te lephone: 305 .673.7411 Rabinowitz Last Name DIVERSITY STATISTICS REPORT Mark ' L First Name Middle Initial The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. Gender: 10 Male 0Female Oother 0 I prefer not to answer. Race/Ethnic Categories: What is your race? 0 African American/Black 0 Asian or Pacific Islander ~ Caucasian/White 0 Native American/American Indian 0 Other-Print Race: -------------------------0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? DYes lKl No 0 I prefer not to answer. Do you consider yourself Physically Disabled? DYes UNo 0 I prefer not to answer this question. Page 6 of6 F:IC LERI$ALLIBOARD AND COMMITTIES DATABASEICHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION .docx Upda ted : June 2020 MARK LAWRENCE RABINOWITZ, M. D., F. A. C. G., A. B. 0. G. 11 645 BISCAYNE BOULEVARD, MIAMI, FLORIDA 33181 305 /538-8835 MEDICAL EDUCATION 1975-1979 University of Miami Miller School of Medicine M. D. Degree received 6/1979 Florida Medical License issued 7/1/1980 EXPERIENCE 1993-Present Miami Beach Community Health Center, Inc., Miami Beach , Florida Chief Executive Officer: 1/30/2014-Present Interim Chief Executive Officer: 5/9/2012-1/29/2014 Chief Medical Officer: 3/24/2004-Present Co-Medical Director & Director Obstetrics & Gynecology Services: 6/10/2003-3/23/04 Volunteer Physician: 1/1/1993-12/31/1994* 1983-2003 Gilibert & Rabinowitz, M . D., P. A., Bay Harbor Islands, Florida : Obstetrics & Gynecology, Private Practice 1979-1983 University of Miami Miller School of Medicine & Jackson Health System: Intern & Resident 1974-1975 University of Miami Biochemistry Department, Research Technician SOC I ETY MEMBERSHIP National Association of Community Health Centers Florida Association of Community Health Centers North American Association for the Study of Obesity American Society of Bariatric Physicians Miami Obstetrical & Gynecological Society American Association of Gynecologic Laparoscopists American Fertility Society American College of Obstetricians & Gynecologists, Fellow 2003-Present 2003-Present 1996-1997 1995-1997 1987-Present 1987 -2000 1987-2000 1986-Present 1985-Present 1983-Present 1983-2000 1883-Present 1983-Present 1979-Present American Board of Obstetrics & Gynecology, Lifetime Diplomat (Recertified: 2000, 2001 , 2008) William A. Little Society Florida Obstetrical & Gynecological Society * Dade County Medical Association Florida Medical Association American Medical Association AWARDS, HONORS & APPOINTED POSTIONS 2016 2016 Florida Association of Community Health Centers , Inc.: Wendell N. Rollason Outstanding Leadership Award Jessie Trice Hero Award Broward Community & Family Health Centers, Inc.: Appreciation Award City of Miami Beach : Health Facility Board Member City of Miami Beach: Health Advisory Committee (Chair 2015-Present) Health Choice Network, Inc.: Board of Directors Member 2016 2018-Present 2014-Present 2008-Present 2008-2018 2008-2018 2006-Present Prestige Provider Service Network: Credentials Committee & Quality Improvement Committee, Member Prestige Health Choice: Quality Improvement Committee, Member United Health Care : Provider Advisory Committee *Due to closure of some entities, the length of time elapsed , and the inability to loca t e records , dates are approximate . MARK LAWRENCE RABINOWITZ, M. D., F. A. C. G., A. B. 0. G. Pagell2 2005 2004-2018 1994-2000 1992-1997 1992-1993 1987-1996 1987-1989 1983-Present PUBLICATIONS Miami Beach Community Health Center, Inc.: Mark Rabinowitz Financial Hero Award Health Choice Network, Inc.: Clinical Committee, Chair* Board of Directors, Miami Beach Community Health Center, Inc. St . Francis Hospital/Miami Beach Community Hospital Credentials Committee, Member: 1993-1997* Credentials Committee, Chair: 1992-1993* Department of Obstetrics & Gynecology, Co-Chairman: 1991-1993* Florida Department of Health, Volunteer Miami Heart Institute Shared Birth Place, Co-Medical Director & Developer : 1987-1996 Department of Obstetrics & Gynecology, Vice Chairman : 1996-1997 Dade County Medical Association, Public Service Committee Voluntary Faculty/Clinical Instructor University of Miami Miller School of Medicine, Clinical Instructor: 1983-2012* Florida International University, Voluntary Faculty: 2008-Present* Barry University, Voluntary Faculty: 2010-Present* Nova University, Voluntary Faculty: 2008-Present Marshall JJ, Rabinowitz, ML. Modification of the Properties ofTrypsin by Covalent Attachment to Dextran. Arch Biochem Biophys 1976. Marshall JJ, Rabinowitz, ML. Stabilization of Catalese by Covalent Attachment to Dextran. Arch Biochem Biophys 1976. Rabinowitz, ML. Throat Swabbing in Epiglottitus (Letter). JAMA 1978. Marshall JJ, Rabinowitz, ML. Preparation and Characterization of a Dextran-Trypsin Conjugate. J Bioi Chem 1981. Rabinowitz, ML, Basson I, Robinson , MJ. Sexually Transmitted Cytomegalovirus Proctitis in a Woman: A Case Report . Am J of Gasterenterology 1988. Rabinowitz, ML, Gilibert, JE, Lenes, BE . Avoiding Blood Transfusion: A Report ofTwo Cases . J Rep Med 1990 *Due to closure of some entities , the length oftime elapsed, and the inability to locate records , dates are approximate. MARK LAWRENCE RABINOWITZ, M. D., F. A. C. G., A. B. 0. G. Page212 AC# 5 5 STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE LICENSE NO. CONTROL NO. 12/07/2019 ME 36822 685096 ci N z N cJ ~ 0 N ~ .. ...: z ... .., 0 > u ~ oo( ~~ ::;) z ~g; oo( ~ w ...., u zit w.._ s ~ ci !:s ~0 IV ::> z a:W 0 THE MEDICAL DOCTOR NAMED BELOW HAS MET ALL REQUIREMENTS OF THE LAWS AND RULES OF THE STATE OF FLORIDA. Expiration Date: JANUARY 31,2022 MARK LAWRENCE RABINOWITZ 11645 BISCAYNE BOULEVARD SUITE207 MIAMI, FL • 33181 Ron DeSantis GOVERNOR DISPLAY IF REQUIRED BY LAW EXPIRATION DATE: JANUARY 31,2022 Scott A Rivtcees MD State Surgeon Genera. (/) w (/) (/) < z w ~ 2 ~j __, ~~ <:I:O Ou..C irOw O~:::l w iiw~ !;( l5~z 0 !!!~~ ~fh~ <1)00 ~ s!( c: ... @t; 0 w ~~ :1 "'w ~ ~j': ·c. t;:;l5 .nlll @5 :::IE"' ~ ~ w (/)...J w ~51 CJ .. ;;:c z g ... UJ < g~ ~ "" !.! Wrt> ~ fa co;;: :1 0~ ~ w ~w i i= zi!' Your license number is ME 36822. Please use It in all correspondence with your board/council. Each licensee is solely responsible for notifying the Department in writing of the licensee's current mailing address and practice location address. If you have not received your renewal notice 90 days prior to the expiration date shown on this license, please visit www .FLHealthSource.gov and click "Renew A License" to renew online. The Medical Quality Assurance Online Services Portal gives you the ability to manage your license to perform address updates , name changes, request duplicate licenses and much more. It's simple. Log onto your MQA Online Services account today at http://flhealthsource .gov/. Select the "Account Login" button to access your account. For changes to your name, address or to request duplicate licenses, choose your selection from the dropdown list under "Manage My License". Your profession will open for renewal 90 days prior to your expiration date . When the renewal cycle opens for your profession, the "Renew My License" header will automatically display on your license Dashboard . ARE YOU RENEWAL READY? The Department of Health will now review your continuing education records at the time of license renewal. To learn more . please visit "~o.hea · Source .go-..AYRR IMPORTANT ANNOUNCEMENTS GROUNDS FOR DISCIPLINE You should be familiar with the Grounds for Discipline found in Section 456.072(1), Florida Statutes, and in the practice act for the profession in which you are licensed. 1:1 5 I