HomeMy WebLinkAboutExhibit B Scope of Work
Exhibit B .
Scope of Work
Mount Sinai
MEDICAL CENTER
June 20, 2005
Mr. Gus Lopez, CPPO, CPPB
City of Miami Beach
Procurement Division
1700 Convention Center Or., Third Floor
Miami Beach, FL33139
Re: RFP NO. 24-04/05, A Medical Services Provider for the Provision of
Various Medical Services that may be necessary or required by the City of
Miami Beach, Local, State, and Federal Laws
Dear Mr. Gus Lopez:
Mount Sinai Medical Center, Occupational Health Center located at 4300 Alton
Road, Lowenstein Building, Miami Beach, Fl 33140, Telephone Number (305)
674-2312, Fax Number (305) 674-2413, Tax Identification Number 59-262442 is
formally responding to YOur Request for Proposal No. 24-Q4/05, A Medical
Services Provider for the Provision of Various Medical Services that may be
necessary or required by the City of Miami Beach, Local, State, and Federal
Laws: The Proposer is appOinting Ms. Linda Arama' as the primary contact
person for this RFP; she can be reached at (305) 674-3910, and her e-mail
address is Larama@msmc.com; Terry Del Rio is the secondary contact person
for this RFP, she can be reached at (674-2312, and her email address is
T delriO{ij)msmc. com.
Should you have any questions conceming the above, please do not hesitate to
contact the undersigned.
Sincerely,
/.~ ~
L~a
Director
Occupational Health Center
Mount Sinai
MEDICAL CENTER
Table of Contents
Scope of Services
A. General................................. ... ... ... ... ... ... ... ...... .. .. '" '" ... ... ... ...... page 1
B. Comprehensive Physical Exams and Drug Testing for
Pre-employment and Promotions... ... ... ... '" ... ... ... '" ...... .. .. .. .. .. . .. .... .. . .. page 2
C. Medical Records............................................................... ...... ....page 3
D. Psychiatric Services... ... ........... ...... ... '" ... ...... '" ... ... ... ... '" ............ .page 3
E. Immunization Program... ... ... ......... ... '" '" ...... ... ... '" '" ... '" ....... '" ....page 3
F. Drug & Alcohol Test Program... ... ... '" '" .. '" ... ... .... ... ... ... '" ... ... .. .... '" page 4
G. Wellness Program... ... '" ... ... ...... ... .. .... '" '" ... '" '" ............... '" '" .....page 5
H. Employee Assistance Program (EAP)............ .............................. ...page 5
I. Fitness for Duty Evaluations/Return to Work and
Rehabilitation Evaluations... '" ... ... '" '" '" '" '" '" ... '" ... '" '" '" '" '" ... '" ..page 6
J. Executive Physical... '" '" ... ... '" ... ...... ... ... '" '" ... '" ... ......... '" '" ... '" ..page 6
K Performance Criteria and Evaluation... ... '" ... ... ... ... ...... ... '" ... ... '" '" .. page 6
L. Communication.............................. ... ... ... '" ... ... ... ...... ... ... ...... ... ... page 7
M. Staffing............ ... ... ... ... '" ... ... ... .. . '" ... '" '" '" '" ... ... .. . ... ... '" '" '" ... . page 7
Occupational Health Center Staffing... '" ... .... .. '" ...... ... '" '" '" ......... ... '" page 7
Occupational Health Center Staffing (cont'd ) ... ... '" '" '" ... '" '" ... . .. .. '" ... page a
Resumes, CV, Certificates, licenses....................................... ..Attachment A
locations and Hours... ... ... '" ... ... ... '" '" ... '" '.. '.. ... ... '" ... ... '" '" '" '" .. .. . page 9
Floor Plan... '" '" ... ... ... ... '" ... '" ... ... ... ... '" ... ... '" ... '" ... ... ... ... '" .Attachment B
Proposer's Experience and Past Performance... ... ... ... .. . ... ... ... ... ... ... ... page 1 0
Proposer's Experience and Past Performance (cont' d) . . .. . . . . .. ... ... ... ... ... page 11
Proposer's Experience and Past Performance (cont'd).... ... .. . . .. ... ... ... ... page 12
Proposer's Experience and Past Performance (cont' d). .. . ... ... ... ... ... ... ... page 13
Fee Proposal... ... .................. ...... ... ... ... .... ... .... ......... ...... ......... .... ..page 14
Fee Proposal (conI' d)... ... ... ... ... ... . .. ... ... ... . . . . . .. .... ... ... ... ... ... ... . . .. . . . . .. page 15
Fee Proposal (conl'd).... ... ............... ... ... ........... ... ... ... ... ... ... ....... ... ..page 16
ProPOsal Documents... ...... ......... ... ... ......... ... ...... ... ...... ............... ...page 17
Campus Map of Mount Sinai Medical Center... ... ... ... ..... ... ... ... ... ..Attachment C
Mount Sinai
MEDICAL CENTER
SCOPE OF SERVICES
A.GENERAL
The Occupational Health Center (OHC) at Mount Sinai Medical Center, a
professional medical services provider and the City of Miami Beach in
accordance with established medical practice, the OHC with its brand new
facilities, based on the physical requirements of the job description provided by
the City, will conduct physical examinations and drug testing as required for pre-
employment on all new hires, promotional exams for classifications where
physical duties greatly vary, return-to-work clearance, rehabilitation
consideration, and other services as required by the City or local, state and
federal laws and regulations. Male and female physicians, licensed in the State
of Florida, will be available to perform examinations upon the City of Miami
Beach's request. Physicians are Board Certified in Internal Medicine or in Family
Practice.
The OHC will conduct and review laboratory results, x-rays, and other medical
reports; evaluate reports and makes appropriate recommendations as needed;
review special medical problems such as return from sick leave, on-duty injuries,
disability, and other medical issues as required; provide reports and medical
opinions when applicable; counsel personnel and job applicants about medical
conditions and findings, and refer to appropriate follow-up care, when indicated.
The OHC will supply the City of Miami Beach with a primary contact, or Project
Manager, who will be assigned to address all questions and concerns of the City.
This contact person will be available for pre-employment issues during all
business hours. A back-up contact will be designated in case the Project
Manager is unavailable. The designated back-up will be fully informed in all
areas. All other staff providing services under the contract will be properly
informed and trained on procedures, forms, changes, and requirements. Any
special instructions will be communicated to all staff.
All medical evaluation results will be reported to the Human Resources
Department within 48 hours from the time the applicant is first seen.
All services will be available a minimum of five (5) days per week during business
hours. The hours are from 7:00 a.m. until 5:00 p.m. Actual service hours are
open to negotiation. The City will have the ability to schedule same day or next
day appointments with the OHC for all services if necessary. In special cases,
and with at least 3 days advanced notice by the City, the OHC will make
arrangements to provide services outside normal business hours, such as
evenings and weekends.
Page 1
The OHC will provide convenient parking at no cost to applicants, employees, or
the City for individuals referred.
With the assistance of the City's Information Technology Department, the OHC
will set up and utilize an electronic mail system compatible with the City. If
requested by the City, all reports and other necessary communication will be
utilized through this system.
The OHC will utilize City forms where required. OHC will review their own forms
with the City. and allow for changes as needed. The OHC will assure that
instructions, changes, and transfer of information and documents will be only with
those individuals or firms designated by the Human Resources Director.
Immediate notification will be made to designated City staff of "no-shows' or any
problems with an individual's cooperation or compliance.
The OHC will provide applicant deadlines for follow up as needed. as determined
by the City's policy.
Individuals referred to OHC should not have a waiting time that exceeds 30
minutes. The OHC will assure COnfidentiality of all records. information,
correspondence both verbal and written.
The OHC will submit a quarterly utilization summary report to the City.
B. COMPREHENSIVE PHYSICAL EXAMINATIONS AND DRUG TESTING
FQR PRE-EMPLOYMENT AND PROMOTION~
Based on the physical requirements of the job description provided by the City,
the Occupational Health Center (OHC) will conduct physical examinations and
drug testing, as required, for pre-employment on all new hires and exams on
promotional applicants, where physical duties greatly vary.
The results of the applicant's physical examination will be reported to the Human
Resources Department within 48 hours from the time the applicant is first seen.
The OHC will permit at least 10 appointments per day and provide capacity for
up to 20 appointments per day. with 3 days advance notice from the City.
The City will have the ability to schedule same day or next day appointments for
pre-employment examinations.
PPD tests will be read by the OHC. Positive results will be handled by the OHC
and will not be referred to the Department of Health, or other facility, unless
agreed to in writing by the City. In any case, there will be no additional charge 10
the applicant for this service.
Police Officer applicants will include tests for heart disease evaluation.
Page 2
Firefighter pre-employment examination will include tests for evidence of AIDS,
Hepatitis, Pulmonary Tuberculosis, or MeningOCOCCal Meningitis.
C. MEDICAL RECORDS
The Occupational Health Center (OHC) will maintain health files for all City
employees. These files that will include establishing and maintaining medical
records regarding injuries and accidents related to employees in accordance with
all State and Federal laws, as applicable. Upon request of the Human Resources
Director, or their designee, the OHC will provide medical records within 24 hours
of the request. Medical records may only be released to the Human Resources
Director, Claims Coordinator or their designee. All requests and designee's
assignments must be made and accepted in writing only
D. PSYCHIATRIC SERVICES
The OHC will be able to provide psychiatric services on an appointment basis
only to all employees of the City as requested by the City. The OHC will prepare
appropriate summary and recommendation reports.
E.IMMUNIZATION PROGRAM
The Occupational Health Center (OHC) will administer an intradermal test for
Tuberculosis exposure on all employees that are necessary and requested. A
chest x-ray may be done in lieu of an intradermal test for Tuberculosis.
The OHC will administer a Tetanus Toxoid Booster Immunization for Police
Officers, Firefighters, Fire Rescue personnel, Waste Collectors and Parks
personnel. This may include other occupations depending on the job
specification and/or individual requirements.
The OHC will administer Hepatitis B vaccine for those City employees with a
potential risk exposure to infected blood or bOdy fluids, as determined by the
City.
The OHC will administer other vaccines that may be required such as measles,
mumps and rubella vaccine or any additional immunizations, tests, vaccines, as
required by local, state, or federal requirements, or by industry recommendations
or guidelines.
The OHC will administer and make available, in accordance to current Federal
guidelines anti-viral medications against the AIDS virus for emergency
responders. These medications will be given within two hours of a significant
Page 3
exposure to the AIDS virus. The City's employees will have access to the
administration of anti-viral medications for the AIDS virus on a twenty-four hour
basis.
The OHC will administer HIVIAIDS baseline tests to sworn Fire Department
employees; and, perform other tests requested by the City to comply with future
Union contracts.
F. DRUG & ALCOHOL TEST PROGRAM
The OHC will conduct a Drug and Alcohol Test Program as required by local,
state and federal law and regulations. This will include a certified Substance
Abuse Professional (SAP), Breath Alcohol Technician (BAT) and Medical Review
Officer (MRO).
The OHC will conduct pre-employment drug tasting on all applicants, as well as
conduct promotional drug and alcohol testing to all safety sensitive applicants
before they actually perform safety sensitive functions for the first time.
The OHC will conduct random drug & alcohol testing on Police Officer personnel.
The OHC will test yearly approximately 400 Fraternal Order of Police employees,
30 Government Association employees, 300 American Federation of State,
County and Municipal Employees, and 200 International Association of
Firefighter employees, and conduct other random drug and/or alcohol testing as
may be specified by the City. The OHC will conduct random, unannounced
testing on safety sensitive employees who drive or maintain vehicles that require
Commercial Driver Licenses to operate, in compliance with the Omnibus
Transportation Act 349CFR40. Fifty percent of these employees will be tested for
drug abuse and 25% for alcohol misuse. The random rate for testing is subject
to change based on the DOT standards and union contracts.
The OHC will conduct testing on employees whose performance could have
contributed to an accident, even if the employee was not cited for a traffic
violation. The OHC/ER will be availability 24 hours per day and 7 days per week.
The OHC will conduct testing on employees when the City observes behavior or
appearance that is characteristic of drug use or abuse or alcohol use or misuse.
The OHC will conduct return-to-duty and follow-up testing for employees who
violate the prohibited alcohol or drug conduct standards. At least 6 unannounced
tests will be conducted in the first 12 months after an employee returns to duty.
Follow-up testing may be extended for up to 60 months following return-to-duty.
Page 4
The OHC will provide drug and alcohol testing services with licensed and
certified personnel and laboratories as required by Local, State, and Federal Law
including, but not limited to, Medical Review Officer(MRO), Breath Alcohol
Technician(BAT), and Substance Abuse Professional(SAP) as required by
D.O.T.
The OHC will conduct annual training for designated City employees on the Drug
Free Workplace Act. The OHC will insure proper and documented chain of
custody during and after sample COllection and testing. .
The OHC has appropriately private facilities to conduct these tests, including a
locked, Secured box for private articles and police weapons.
G. WELLNESS PROGRAM
The Occupational Health Center (OHC) will provide annual health screening and
health education at a minimum of two (2) job site areas within the City. The topics
will be mutually agreed upon by the City and OHC and the OHC will provide
information on drug use and treatment resources to all safety sensitive drivers.
H. EMPLOYEE ASSISTANCE PROGRAM tEA~
The Occupational Health Center (OHC), at a minimum, will provide the fOllowing
services: Comprehensive professional services directed towards diagnosis and
resolution of emotional or behavioral problems affecting our employees.
It is intended that the program provide up to a total of three (3) visits per
employee and/or immediate family member per year before invoking insurance
coverage or other appropriate resources. This may include counseling,
diagnosis, referral, and/or fOllow-up for adolescents, family crisis counseling,
counseling on issues including, but not limited to finances, illness, legal
problems, marital, stress and anxiety, violence, vocational counseling, aoo
substance abuse counseling as well as customary psychological or medical
counseling. The designated program will maintain regular office hours, Monday
through Friday, and will be available to respond to emergencies twenty four
hours per day, seven days per week.
The personnel assigned to provide these services will be Employee Assistance
Plus, Inc., who licensed in the State of Florida under Chapter 491 as a Mental
Health Professional to perform counseling.
Page 5
To facilitate the transition and provide information to all City employees regarding
EAP, the Occupational Health Center at Mount Sinai Medical Center will initiate
orientation meetings with managers and union representatives to familiarize them
with the process. Employee Assistance Plus, Inc., will provide informational
posters and flyers to all departments and brochures for all employees.
I. FITNESS FOR DUTY EVALUATIONs/RETURN TO WORK AND
REHABILITATION EVALUATIONS
The Occupational Health Center (OHC) will evaluate employees' ability to
continue employment in their current capacity and to assess and recommend
reasonable accommodation for other job opportunities for which they may be
qualified. This may include a physical examination, retum to work evaluation,
psychological and/or psychiatric evaluation, and/or any reports to be completed
as requested by the City for fitness for duty. Evaluations will be completed within
two working days of the request, and on the same day in case of an emergency.
Summary City forms and recommendations will be forwarded to the City within
24 hours of the appointment. The OHC shall assist the City in the evaluation and
verification of questionable family leave requests.
J. EXECUTIVE PHYSICAL
The OCCUpational Health Center will recommend an annual medical physical
evaluation and wellness program for executive staff.
K. PERFORMANCE CRITERIA AND EVALUATION
Each month the City shall evaluate the Occupational Health Center's
performance based on the scope of services, and employees, applicants, Human
Resources and Risk Management Departments' feedback. The criteria to be
rated will include, but is not limited to, pre-employment, EAP, drug and alcohol
screening, fitness for duty determinations, communication on all requested
results, and designated contact availability. The criteria to be rated will change
based upon the needs of the City.
Page 6
L. COMMUNICATION
With the assistance of the City's Information Technology Department, the
Occupational Health Center will set up and utilize an electronic mail system
compatible with the City, all reports and other necessary communication will be
utilized through this system. Any and all aSSOCiated costs with the set up, other
than the City's set up, will be absorbed by the OHC.
The OHC will have qualified personnel available during all business hours to
SUpply all services, including final physician sign off, for pre-employment
examinations. All test results under the Scope of Services and the Agreement
will be communicated only to the Human Resources Director, or their designees.
M. STAFFING
The Occupational Health Center will staff Sufficiently to supply all services stated
in the Scope of Services and the Agreement. The OHC will increase staffing if
necessary 10 fully comply with what has been stated in the Scope of Services.
OCCuDational Health Center Staffing
Linda Arama, Director, Project Manager
Approximately 20 years experience with Miami-Dade County as Director of OHC
Terry Del Rio, RN (back up contact person)
Certified Intoximeters Breath Alcohol Instructor (Intoximeters Model Alcomonitor
CC), Certified DOT Drug Screening Technician, CAOHA Certification, Drug
Screening Coordinator
Lucy Castellanos, ARNP
Patricia Wilson, LPN
Occupational Health Certification Drug/Alcohol Screening, DOT, BAT
Kenneth Kaplan, M.D.
Medical Director of Occupational Health Department, Medical Review Office,
SAP, Certified in Workers Compensation
D. Allen Young, M.D.
Medical Review Officer. SAP
Gerardo Jose Minsal-Ballester, M. D.
Samira Habibnejad, M.D.
Page 7
Ira Feldman, M.D.
Board Certified Cardiologist
Matthew Zucker, M.D.
Board Certified Cardiologist
Manuel Viamonte, Jr., M.D.
Board Certified Radiologist
Alan Drexler, M.D.
Medical Director of Radiology
Omaira Diaz
Medical Assistant
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT),
Toledo Murray
Medical AssistanUPatient Representative
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT),
Meredith R. Portee
Medical AssistanUPatient Representative
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT),
Latonya Danials
Medical Assistant
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT),
Enid Edwards
Medical Assistant
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT),
Yeisy Perez
Medical Assistant
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT), .
Alba Alfayate
Medical Assistant
Certified DOT Drug Screening Technician, Certified Breath Alcohol Technician
(BAT)
Page 8
Attachment A
Resumes, Curriculum Vitae,
Certificates, Licenses
Kenneth J. Kaplan, M.D.
1680 Michigan Avenue
Suite 912
Miami Beach, Florida 33139
Office (305J534-0503/Fax (305)675-0106
'eoona' Data:
Place of Birth - New london, Connecticut
Date of Birth -- December 23, 1959
Personal and Professional References on Request
Certification and Ucensure:
Board Certified Internal Medicine
Medical license - Commonwealth of Mass.
Medical license - State of Florida
August 1999
Sept. 1988 - Dec. 1995
Oct. 1994 - Present
Prot..,'ona' SocIety MembershIps:
American Medical Association
Member in good standing with. AAMR.O
Certified Substance Abuse Professional
Education:
Medical Doctor- Tufts University School of Medicine Sept. 1981- May 1985
Boston, Massachusetts
B.5.M.E. - Tufts University College of Engineering Sept. J 977- May 198 J
Medford, Massachusetts
Sumo Cum laude
Graduate of New London High School - June 1977
New london, Connecticut
Valedictorian
Honors:
Tau Beta Pi Engineering Honor Society May 1980
Tufts Unlv~rsfty - Medford, Massachusetts
Post Graduate TraInIng:
Residency In Internal Medicine. Faulkner Hospital JUly 1985 _ June J 988
Associate Institution of Tufts University School of Medicine
Boston, Massachusetts
Chief Residency in Ambulatory Medicine. Faulkner HOSPital July 1988- June 1989
Associate Institution of Tufts University School of Medicine
Boston, Massachusetts
Prole.slonal or TeachIng AppoIntments:
Private Solo-Practice Internal Medicine
Miami Beach, Florida
July 2CX)Q - pres.
Medical Director- Mount Sinai Medical Center
Department of Occupational Medicine
Miami Beach, Florida
Staff Physician - Around the Clock Medical Center/
Personal Care Medical Center
North Miami Beach, Florida (part time)
Staff Physician - Scott English, M.D., PA
South Florida Geriatrics
North Miaml8each, Florida
Staff Physician - Dade Medical Care, Inc.
A ventura, Florida
Private Solo Practice Intemal Medicine
Boston, Massachusetts
Staff Physician - Express Care Clinic
Faulkner Hospita/- 80ston, Massachusetts
Director of Ambulatory Medical Clinic
Faulkner Hospital- 80ston, Massachusetts
Instructor in Medicine - Tufts Univ. School of Medicine
~.nt:
Dialysis Technician - Boston. Massachusetts
Mechanical Engineer
General Dynamics Electric Boat Division
Groton, Connecticut
Associate Engineer .
Naval Underwater Systems Center
New london, Connecticut
April 2000 - pres.
Feb. 2000 - pres.
Sept. 1999 - Feb. 2000
Oct. 1994 - Sept. 1999
Nov. 1991 - Oct. 1994
July 199 J - Oct. J 994
July 1989 - June 1991
July 1987 - June 1994
June 1982 - Aug. 1982
June 1981 - Aug 1981
June 1980 - Aug 1980
June 1979 - Aug 1979
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THIS IS TO CERTIFY THAT
having presented to the Executive Board of the American Association of
' Medical Review Officers satisfactory evidence of prescribed qualifications and
'.' having passed an approved examination before the
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afertifiW ~1 ~iefu @ffker
and by order of the MMRO Board has ~een entered as such in the
AAMRO Registry of Certified Medical Review Officers
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In Mia...., Florida
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DEPARTMENT OF HEALTH
DIVISION OF MEDICAL QUALITY ASSURANCE
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DATE LICENSE NO. CONTROL NO.
11/19/2003 ME 66552 . 112886
t MEDICAL DOCTOR
'led belqw has met all requirements of
laws and rules of the stale of Florida.
iralion'Date: JANUARY 31 2006
. .
INeTH .JOSEPH KAPLAN
) MICHIGAN AVENUE
re 912 .::'
VII BEACH, FL 33139
QUALIFICA TION(S):
DISPENSING PRACTITIONER
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Resume
Terry A. Del Rio
225 Reinette Drive
Miami Springs, Florida 33166
Telephone: (305) 885 - 4491 (Home)
(305) 674 - 2312 (Work)
Employment History
1982 to PreleDt Mt. Sinai Medica. Center, Miami Beach, Florida
1982 to 1985 7 main post operative care, R.N. for acute care of pre and
post operative patients. Primary responsibilities: Monitoring of patients,
dispensing of medication orders, assisting physicians with procedures and
other related nursing task.
1985 to 1993 Vascular Laboratory, Performed arterial and venous
peripheral vascular studies, carotid doppler studies and cardiac stress test.
Monitored patients and assisted physicians with procedures in Nuclear
Medicine and Ultrasound Departments.
1993 to present Occupational Health Department, Primary
responsibilities: Develop, implement and evaluate Drug! Alcohol programs
including DOT, Drug Free Workplace and NIDA. Other duties include
perfonning the following test: hearing, puhnonary, glaucoma, vision,
stress test and other nursing related task.
Education
Graduated from Miami Dade Community College, Miami, Florida.
Associate Degree of Science
Professional Licensure and Certification
Current - Florida R.N. License # 1364422
Current - Certified Breath Alcohol Technician (BAT)
Current - Certified Authorized Calibration Technician
Current - Certified Intoximeters Breath Alcohol Instructor
(Intoximeters Model A1comonitor CC)
Current - Certified Occupational Noise Exposure and I-Iearing
Conservation by Council for Accreditation in Occupational
Hearing Conservation (CAOHC)
Alba Alfayate
60 NE 39 Street
Apt. 318
Miami, FL 33137
Objective:
To continue my professional career in the Medical Field.
Experience:
1985- to present
Mount Sinai Medical Center/Miami Heart
Lead Technologist/Medical Assistant
Performance:
. EKG
· Stress Lab Test
· Preparing charts for the doctor with results
· Blood pressure
· Drug Screening
· Vision Screening
. Hearing
· Pulmonary Testing
· Vital Signs
· PPD Vaccines
Certification:
Cardio Vascular Tehnology
Education: S1. Mary's High School New York, NY
Diploma
Miami Dade Community College, Miami FL AA Degree
Gelbi School of Medical Technology, Miami, FL Certification
National Alliance of Cardiovascular Technician, Certification
Reference: Available Upon Request
FRCI1 : MT SINAI oce HEALTH
PHONE NO. 305 674 2860
Apr. 09 2004 11:51AM Pi
(954) 894-8) 98
7841 Vent!tian Street
Miram.... Fl 33023
Objective:
Enid Edwards !
._, " u, .'_
To continue my professional career in the Medical .eld.
i '
I '
I
Mount Sinai Medical Center/Miami Beach!
Medical Assistant
Experienee:
1997 - present
· Venipuncture
· PPD Vaccines
· Urine dip stick
· Blood cultures
· Vital signs
· Assisting Dr. with Pap Smear
· Vision Screening
· Hearing I
· Pulmonary Testing ! :
· Drug Screening : '.
· Alcohol Testing !
· Filing i '.
· Preparing the charts for the doctor with res~ts
j:
i.
! '
i
i '
1996 - 1997 CAe Medical CenterlMiami, FI
Medical Assistant
I :'
j'
I
,
· Venipuncture, Vital Signs, EKG, Blood cul~Ures, Assisting the Dr.
with Pap Smear, Assisting with minor surg~ty.
j
i
i'
I,
f . :
· Venipuncture, EKG, Blood cultw-es, Vital ~igns, Filing, Entering
patient Pre-op testing in the computer. i
1987 - 1996 Parkway HospitaJ/Miami, FI
Medical Assistant
1985 -1987 Dr. Stanley Newman/Miami, Fl
Medical Assistan.t
I.
· VenipWlcture, EKG, Filing, Assisting with hunor surgery.
!
I
i
I'
FROM MT SINAI Dee HEALTH
PHONE NO. 305 674 2860
Apr. B9 2804 11: 52F11 P1
~,
_.cation:
Present
Miami-Dade Community College
1985
Medical Ans Training CenterlMiami, Fl
· Medical Assistant
]971 - 1976 Catherine High School. Jamaica West Indies
· Graduated, High School Diploma
Interests: Music, Lawn Tennis & Reading
Reference: Available Upon request
Yeisy Perez
Objective: To continue ~y professional career in the Medical field.
(305) 62 J 2025
17S20N.W. 41 Ave.
Miami, FJ 33055
Experience:
2002 - present
Mount Sinai Medical CenterlMiami Beach
Medical Assistant
· Venipuncture
· PPD Vaccines
· Urine dip stick
· Blood cultures
· Vital signs
· Assisting Dr. with Pap Smear
· Vision Screening
· Hearing
· Pulmonary Testing
· Drug Screening
· Filing
· Preparing the charts for the doctor with results
2000 - 2002 All Medical Agency/Miami, Fl
Medical Assistant
· Venipuncture, Vital Signs, EKO, Blood cultures, Assisting the Dr.
with Pap Smear, Assisting with minor surgery.
1999 - 2000 Phlebotomy Home ServicesMiami, Fl
Phlebotomy Tech
· Venipuncture, Drug Screening & DNA
Education:
Present Miami Educational Center
1998 - 1999 National School of TechnologylMiami, FI
· Medical Assistant
1995 - J 998 Miami Carol City Senior High
· Graduated, High School Diploma
Interests: Music, Dancing & Reading
Reference: Available Upon request
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CURRICULUM VITAE
NAME:
Gerardo Minsal, M.D.
ADDRESS:
4300 Alton Rd
Miami Beach, Fl; 33140
PHONE:
ph: (786) 797-9699
Beeper: (305) 839-2248
E-mail: GMINSAl@
hotmail.com
EDUCATION AND TRAINING:
1978
Graduated - La piedad High school
Puerto Rico.
1979
university of Puerto Rico, Rio Piedras
campus, Puerto Rico.
Doctor of Medicine, Universidad Central del
Este, School of Medicine, San Pedro de
Macoris, Dominican Republic.
Internship, caguas Regional Hospital.
Caguas, Puerto Rico.
Internal Medicine, Caguas Regional Hospital,
Caguas, Puerto Rico.
Geriatric Medicine, university of Hawaii at Manoa,
Kuakini Medical Center, Honolulu, Hawaii
1983
1987-88
1988-91
1991-93
EXAMINATIONS:
1984
Educational Commission for Foreign Medical
Graduates.
1987
1992
Puerto Rico Board of Medicine
FLEX
Page 1
1996
199B
American Board of Internal Medicine
certification of Added Qualification in Geriatrics
PROFESSIONAL EXPERIENCE:
Dec. 199B-present: Staff Geriatrician, Mount Sinai Medical Cent
er
of Greater Miami, 4300 Alton Rd, Miami Beach
Florida. 33140
Jan. 199B- Nov 199B: Associate Director, Life Care Nursing Home,
Crossing Blvd, Orange park, Fl.
Nov. 1995- Nov 1998: Medical Director, Medwise Center at two loc
ations,
nd 31B9 US
5500 Blanding Blvd. # 1, Jacksonville, Fl a
Hwy 17, Green Cove Springs, FL.
Nov. 1996-July 199B: Medical Director, Oak Terrace Nursing Home,
Green Cove Springs, Fl.
Nov 1996-Nov 199B: ACLS Medical Course Director, Heart Start,
Orange park, Florida.
1996-1998: Utilization Committee. Member. Orange Park Medical
Center. Orange Park, Fl.
Sept.-Oct 1995: Medical Director, la Posada Nursing Home,
Miami, Fl.
1993- May 1995: Director of Geriatric and Family Consultation
services, Division of Geriatrics,
Department of Medicine, John A. Burns
School of Medicine, University of Hawaii,
Honolulu, Hawaii.
Aug 1993-Jun~1995: Assistant Professor of Medicine,
Page 2
Division of Geriatrics, Department of
Medicine, John A. Burns School of Medicine,
university of Hawaii, Honolulu, Hawaii.
Aug 1993-Jun 1995: Director of Medical Students, Division
of Geriatrics, Department of Medicine, John
A. Burns School of Medicine, university
of Hawaii, -Honolulu, Hawaii.
1992-1995: Advance Cardiac Life Support Instructor,
Queen's Medical Center, Honolulu, Hawaii
MILITARY EXPERIENCE:
April 1997-present: Director of Medical Section, 202 RHS, Florida
Air National
1991-May 1995:
ening Program.
Guard, Camp Blanding, Starke, Florida.
Hawaii Army National Guard, Honol~lu, Hawaii
officer in charge of the cardio-vascular Sere
1988-1991:
Puerto Rico
Puerto Rico Army National Guard, Juana Diaz,
OTHER PROFESSIONAL EXPERIENCE:
Page 3
1991-1995: physician consultant, Honolulu Heatt
Program, Kuakini Medical Center, Honolulu
Hawaii.
HONORS AND AWARDS:
Army .Commendation Medal, Puerto Rico Army Nat;onal Guard, 1990
State Active Duty, Hawa;i Army National Guard, 1993. Hurricane In;
ki relief mission.
Glaxo Travel Grant 1993
MEDICAL LICENSURE:
Florida: ME006450B
PROFESSIONAL ORGANIZATIONS:
American Medical Association
American Geriatrics Society
Florida Medical Association
American College of physicians
American Medical Directors Association
COMMUNITY AND STATE ORGANIZATIONS:
1993-1995 Member, Immunization Task Force, Department of Health, H
onolulu, Hawaii
SELECTED RESEARCH:
Page 4
Principal Investigator, Suicide: The Honolulu Study. Poster presen
tation at the American
Geriatrics Society. A study to investigate the suicide frequency i
n a multi-ethnic
community.
Page 5
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The MEDICAL DOCTOR
named below has met aU requirements of
the laws and rules of the state of Florida.
Expiration Date: JANUARY 31, 2006
GERARDO JOSE MINSAl-BALlESTER
GREENSPAN MEDICAL GROUP
4300 ALTON ROAD OPD
MIAMI BEACH, Fl 33140
-
DATE LICENSE NO. CONTROL NO.:: ..'::
..c..:..
119913 .'
12/30/2003 ME 64508 .'.-,.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
DIVISION OF MEDICAL QUALITY ASSURANCE
.....~.
~ ~?.,~
- O. AGWUNOBI. M.D., M.Q.A.:.
SECRETARY:. :.i:: .'.
DISPlA Y IF REQUIRED BY lAW
CERTIFICATE OF LIABILITY INSURANCE PATE (MMJOOV'()
..' OWU200S
PRODUCER .345-949-7988 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY AND
MARSH MANAGEMENT SERVICES CAYMAN LTD. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTFICATE
DOES NaT APJEND, EXTEND OR ALTER THE COVERACE AFFORDED BY THE
P.O. BOX 1051 GT PQ.IeIES BELOW.
3RD FLOOR. FIRSTCARBBEAN HOUSE COMPANIES AFFORDING COVERAGE
GEORGETOWN.CRANDCAYMAN COMPANY fvO..NT SI~1 MEDICPL CENTER a=
CA VMAN ISLANDS. B.W.I. A FLffilDA QJJlR~1EE C~ATlCN
iNSURED COMPANY
MOWlt Sinai Medical Center of Florida, Inc, B
4300 Alton Road COMPANY
Miami Beach, FL 33140 C
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE PU-/CIES OF INSURANCE USTED BELeM' HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU.. THE TERMS. EXCWSIONS AND CONCHICtJS OF
SUCH POUCIES. Ut.tlTS SHONN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EHPlRATION LIMITS
LTR OnE oOo(til MfOOYV) DA TE -(M)(MMlDDIYV)
GENERAL LIABILITY - SIR GENE~LAGGREOATE S
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COMMERCIAL GENERAL LIABIUTY PRODUCTS - CO MPJOP AGG.
n ClAIMS MADE DOCCUR PERSO~L & ArN INJURY S
OWN:R'S & CONTRACTOR'S PROT EACH OCCURRENCE S
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AUTOMOBILE UABlLlTY
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--- ALL OWNED AlITOS
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""-- SCH:DU.EDAUTOS IP.r person) I
-
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NON.QWNEO AUTO S (Per aceidel!t
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PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S
r--
ANY AUTO OTI-ER THAN AUTO ONLY:
r-- EACH ACCIDENT S
r--
AGGREOA TE S
A EJl:ESS LIABILITY EACH OCCURRENCE S 5 000 000
f;1~MSRELLA FORM MSMCFGC-PR-A-05 02101105 0210 V06 AGGREGATE S 5.000 000
X OTH:R THAN UMSREUA FORM S
I~C STATU. , I~TH
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LIABILITY
EACHACCIDENT S
TI-E PROPRIETOR! B:OCl DISEASE-POLICY UMIT .
PARTNE~XECUnVE DISEASE-EACH EMPLOYEE
OFFICERS ARE: EXCL S
OTHER
CLAJMS MADE PROFESSIONAL SIR S~ ,000,000
A LIABILITY IS IN EXCESS OF SELF
INSURED RETENTION
DESCRIPTIONS OF OPERATIOHSI\.OCAJ/ON~HICLESJSR:CIAL ITEMS
INSURED: GERARDO MlNSAL, MD. RETRO DATE: 01-DEC-98.
CERTlFICA TE HOLDER CANCELLAnON
SHOU.O ANY OF THE ABOVE oeSCR/BED POUCIES BE CANCEUEO BEFORE Ti-E
EXPIRATION DATE Ti-EREOF, THE ISSlANO l.;OMf'AM' WILL er-lDE."VOR TO At"'L
30 ~YS WRITTEN OOTlCE TO TI-E CERTIFICATE HOLDER NAMED TO Ti-E LEFT,
Mount Sinai Medical Center of Florida, Inc. BUT FAILI.RE TO MAIL SUCH NOnCE S~LL IMPOSE N) OalGATlON OR
LIABILITY OF AM' tq~ UPON THE COMPANY, ITS AGENTS OR
4300 Alton Road REPRESENT A nVES.
Miami Beach, FL 33140 AUTHORIZED AEPIU:SENTATl\lt:
D. Allen Young, M.D.
Mount Sinai Medical Center
4300 Alton Road
Miami Beach, Florida 33140
Phone: 305-674-2423
E-mail: ayoung@msmc.com
Education:
University of Kansas Medical Center, Kansas City, Kansas
Resident in Internal Medicine, June 1995 through June 1998
University of Kansas School of Medicine, Kansas City, Kansas
Doctor of Medicine, May 1995
University of Michigan, Ann Arbor, Michigan
Master of Arts, Economics, December 1990
Universite de Franche-Comte, Besan~on, France
Non-degree Student of French and Mathematics, September 1988 to May 1989
University of Kansas, Lawrence, Kansas
Bachelor of Arts, Highest Distinction, Economics, May 1987
Work History:
Mount Sinai Medical Center, Miami Beach, Florida, September 2001 to Present
. Associate Program Director of the Internal Medicine Residency since October 2003
. Physician Advisor to the Medical Center for utilization review, quality assurance, and
. clinical ethics
. Supervisor of 37 residents in their weekly outpatient clinics
. Attendingfor the inpatient or consultation teaching services monthly
. Provider of outpatient and inpatient care for private panel of patients with 3 other
internists
. Medical Director for Employee Health Services
South Beach Medical, P.A., Miami Beach, Florida, February 2000 to June 2001
. Private practice with 2 other internists, primarily managing HIV-infected patients
. Provided inpatient care at Mount Sinai Medical Center
Internists of Kansas City, P.C., Kansas City, Missouri, September 1998 to September 1999
. Private general internal medicine practice with 3 other internists
. Provided inpatient care at Trinity Lutheran Hospital
. Managed HI V-infected patients at the hospital's Infectious Disease Clinic
D. Allen Young, M.D.
Page 2
Board Certification:
American Board of Internal Medicine, Diplomate, 1998
United States Medical Licensure Examination, Step I 1993, Step II 1994, Step ill 1996
Medical Licensure:
Florida, No. ME 77468, February 10, 1999
Committee Memberships (Mount Sinai Medical Center):
Residency Management Team
Academic Affairs Committee
Medical Services Review Committee (Quality Assurance)
Medical Management Advisory Committee (Utilization Review)
Ethics Committee
Health Infonnation Management Committee
Clinical Competency Committee, Internal Medicine Residency
Interview Committee, Internal Medicine Residency
Pain Management Team
Professional Memberships:
American College of Physicians, 1995 to Present
Association of Program Directors in Internal Medicine, 2003 to Present
American Academy of HN Medicine, 2001-03
American Medical Association, 1991-2001
American Association for the Advancement of Science, 1996-98
Presentations:
The Antiphospholipid Syndrome, Resident Conference, University of Kansas Medical
Center, December 1997
Unsuspected Cat Scratch Disease, Kansas Chapter of the American College of
Physicians, Overland Park, Kansas, August 1996
The Role of Mast Cell Factors in Cytotoxicity and Nitric Oxide Production by
Macrophages, Student Research Forum, U ni versi ty of Kansas Medical Center,
March J 993
D. AUen Young, M.D.
Page 3
Research:
Isolation and Culture of Human Placental Mast Cells, University of Kansas Medical
Center, Division of Allergy, Immunology and Rheumatology, August 1996;
Daniel 1. Stechschulte, M.D., Supervisor
The Role of Mast Cell Factors in Cytotoxicity and Nitric Oxide Production by
Macrophages, University of Kansas Medical Center, Division of Allergy,
Immunology and Rheumatology, June to August 1992; Daniel J. Stechschulte,
M.D., Supervisor
Honors:
Graduate:
University of Michigan Regents Fellowship, 1989-90
Rotary International Student Exchange Fellowship, 1988-89
Undergraduate:
Phi Beta Kappa
Phi Kappa Phi
College Honors Program
Summerfield Scholarship, 1984-87
R. S. Howey Award, 1987, Achievement in Economics
A. J. Boynton SCholarship, 1986-87, Achievement in Economics .
Paul B. Lawson Award, 1986, Highest Academic Record through the Junior Year
Martha Cook Clarke Scholarship, 1984, Achievement in Liberal Arts
Veta B.Lear Award, 1984, Highest Freshman Academic Record
Freshman Honors Scholarship, 1983-84
References:
DIl Allen Young, M.D.
, Page 4
Gloria B. Weinberg, M.D., F.A.C.P.
Vice Chair, Department of Medicine
Program Director, Internal Medicine Residency
Mount Sinai Medical Center
4300 Alton Road
Miami Beach, Florida 33140
Phone: 305-674-2423
Eugenio Angueira, M.D.
Regional Scientific Director, South East Region
Novo Nordisk Phannaceuticals, Inc.
180 Momingside Drive
Coral Gables, Florida 33133
Phone: 305-667-2466
Paul Katz, M.D.
Vice President of Academic Affairs and Research.
Mount Sinai Medical Center
4300 AIton Road
Miami Beach, Florida 33140
Phone: 305-674-2633
j
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/. DANA ALLEN YOUNG. MD ::.:..:' :):~~'~ ';~'~~i,'.,; ':I~:: ~~ :~~:~,:~ :_:~ .:'--:. "'::'<~A:';: .
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CERTIFICATE OF LIABILITY'NSURANCE 01j31/2005
PRODUCER ' . 345-949-7988 THIS CERTIFICATE IS ISSUED AS A ftMnER OF INFORMATION ONLY AND
MARSH MANAGEMENT SERVICES CAYMAN lTD. CONFERS NO RICHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAce AFFORDED BY THE
P.O. BOX 1051 OT POLICIES BELOW.
3RD FLOOR, FIRSTCARBBEAN HOUSE COMPANES AFFORDING COVERAGE
GeORGE TOWN, GRAND CAYMAN COMPANY MCLNT SINAI MEDICAL CENTER CF
CA YMAN ISLANDS, B.W.I. A FlCRlDA GJPRA\lTEE CCRPCRATICI\I
iNSURED COMPANY
MOWlt Sinai Medical Center of Florida. Inc. B
4300 Alton Road COMPANY
Miall1i Beach. FL 33140 C
COMPANY
0
COVERAGES
THIS IS TO CERTIFY THAT THE PWCIES OF INSURANCE USTeo BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AIlOVE Fm THE POUCV PERIOD INDICATED
NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT IMTH RESPECT TO WHICH THIS CERTIFICATE OlAV BE
ISSUED OR....V PERTAIN. THE INSUAANCE AfFORDED BV THE POlICIES DESCRIBED HERE" IS SUBJECT 10 AU. THE TER"S. EXCLUSIONS AND CONOTlGlS OF
SUCH POUCIES. UMITS SHONN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
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LTR aUE .Qb~MIOOOY) OA TE -Ol(MWOOJYY)
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PARTNE~XECUT~e DISEASE-EACH EMPLOYEE
OFFICERS ARE: EXCL I
OTHER
CLAIMS MADE PROFESSIONAL SIR $5.000.000
A LIABILITY IS IN EXCESS OF SELF
INSURED RETENTION
OESCRlPrIOHS Of OPERATIONSllOCATlONSiVEHlCLESISA;CIAl lJEMS
INSURED: D. AlLEN YOUNG, MD. RETRO DATE: 04-SEP-OI.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE oeSCRlBED POUCIES BE CANCEUED BEFORE n..e
EXPIRA TlON DArE n-EREOF, THE ISSUNG COMPANY WIU ENCEAVOR TO MAil
30 ~ YS WRIn-EN NOTICE TO Tt-E CERrIFlCA TE HOLDER NAMED TO TH: LEFT,
Mowlt Sinai Medi~aJ Center of Horida.lnc. BUT FAILURE TO MAIL SUCH N:lTlCE S,""lL IMPOSE m o EilIGA TI')N OR
lIABILITY OF ANY ,qN) UPON TI-E COM PAM' . ITS AGENTS I)f(
4300 Alton Road REPRESENTA TIVES
Miami Beach, FL 33140 AUTHORIZED REPRESENTATI~
;
Personal Information:
Date of birth:
Citizenship:
Marital Status:
Languages:
Education:
Graduate:
Post graduate:
Positions held :
Oct 2003- Present
June 1 999-July 2000
Dec ) 998-May ] 999
June J 998-Nov ) 998
SAMIRA M. HABIBNEJAD, M.D
143] S\V ) 71 Terrace
Pembroke Pines, FL 33027
Home: (954) 499-5923
shabibnejad@yahoo.com
February) 8, 1969
USA
Married .
English, Farsi
] 987-] 995
Iran University of Medical Sciences
Tehran, Iran
Medical Doctor degree
2002-2003
Mount Sinai Medical Center
Miami Beach, FL.
Internal Medicine Residency
2000-2002
Easton Hospital
Easton, PA.
Internal Medicine Residency
I nternist, Medical attending
Out Patient Department of
Mount Sinai Medical Center
Miami Beach, FI
FelJow of Special Immunology
University of Miami School of Medicine
Jackson Memorial Hospital
Miami, FL.
Observer, Department of Medicine
Jackson Memorial Hospital
Miami, FL.
Research Coordinator
Interventional Cardiology
July 1995-Mar 1997
Resea rc h:
Medical Licensure:
Certifications:
Presentation:
Societv Membership:
References:
Cedars Medical Center
Miami, FL.
General Physician
Public Health Center
Bandar Abbas) Iran
Double blind study to detennine safety and efficacy
of anti platelet agents in post PTC A patients.
Cedars Medical Center, Miami, FL.
State of Florida, ME882]4 (Expires on 1/31/2005)
ECFMG -Certified Jan.29, ]999 (Certificate No. 0-579-896-2)
" Chryseobactrium meningosepticum cellulitis
following Jet ski accident. "a case report.
Pennsylvania Coalition for Internal Medicine
ACP/ ASIM. (Pittsburgh, PA. Nov. 2001)
American College of Physicians 200 I - Present
American Medical Association 2002 - Present
Pennsylvania Medical society 2000 - Present
Gloria Weinberg, M.D, F.A.C.P.
Program Director of Internal medicine
Mount Sinai Medical Center, Miami Beach, FL.
(305) 674-2053
Eugenio Angueira M.D.
Associate program Director of Internal Medicine
Mount Sinai Medical Center, Miami Beach, FL.
(305) 674-2438 .
\Vesley Kozinn, M.D, F.A.C.P.
Director of Medical Education
Easton Hospital, Easton, P A
(6] 0) 250-4906
David Kemp, M.D, F.A.C.P.
Program Director oflntemal Medicine
Easton Hospital, Easton, PA.
(610) 250-4515
Stephen Symes, M.D.
Associate Program Director of Internal Medicine
University of Miami School of Medicine
1ackson Memorial Hospital, Miami. FL.
(305) 243-4598
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STATE OF FLORIDA ACtI . ...
DEPARTMENT OF HEALTH 1 5'40.322
. DIVISION OF MEDICAL aUAlITY ASSURANCIt- ......
DATE LICENSE NO. CONTROL NO.
10/14/2004 ME 88214 133901
The MEDICAL DOCTOR
named below has met all requirements of
the laws and rules of the state of Florida.
Expiration Date: JANUARY 31. 2007
SAMIRA MAHMOUD' HABIBNEJAD ...
~ ~~~~<
,
CERTIFICATE OF LIABILITY INSURANCE DATE (MMfOOV'()
01/31/2005
.
PRODUCER 345-949-7988 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONl. Y AND
MARSH MANAGEMENT SERVICES CAYMAN L TO. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AlIENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
P.O. BOX 1051 GT POLICIES BELOW.
:fD FLOOR, FIRSTCARIBBEAN HOUSE COMPANES AFFORDING COVERAGE
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4300 Alton Road COMPANY
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NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ~Y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
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DESCRIPTIONS Of OPERATlOHSJlOCATlONSlVEHICLESISR:ClAlIlEMS
INSURED: SAMlR.O\ HABffiREJAD. MD. RETRO DA TE: 01-Ocr-03.
CERTIFICATE HOLDER CANCELLATION
SHOUlD ANY OF THE ABOVE DESCRIBED POUCIES BE CAN:ELlEDBEFORE TH:
EXPIRA TlON OA TE THEREOF, THE ISSUING COMPANY V'41ll EN[EAVOR TO IiMIL
30 ~YS WRITTEN ,..,nCE TO THE CERTIFICATE HOLDER ~MED TO THE LEFT,
MOWlt Sinai Medical Center of FJorida, Inc. BUT FAILLfiE TO MAIL SUCH ,..,nCE S~lL IMPOSE to 081I~ATlON OR
LIABILITY OF Am 1<Jt<l UPON THE COM PAm. ITS AvENTS OR
4300 Alton Road REPRESENTA TI YES
Miami Beach. FL 33140 AUTHORIZED REPRESENTATI\oE
CURRICULUM VITAE
Arniel Levin M.D.
~""."'~".""'."""."'~'."'.''''.'-'-. "'-""'l~'-'. "T""~~...~'._;''''''. .....!~.~..-.--!....'1.."l\;.:"f.:!-~>::..~.. .-.... -~""""'m~' ". .'. ..l"-:":tlI.....-.a. I
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Home
4101 Pine Tree Drive #7J8
Miami Beach, FL 33 140
Home: (305) 535-8298
Cell: (305) 965-21 I I
Visa: HIB
Office
Mount Sinai Medical Center
4300 Afron Road
Miami Beach, FL 33140
alevin(@mslllc.com
Phone: (305)-674-2430
~...- ..-...~.._._B..,.~-............W'...~::p.1.:....,~_.
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M.D.
B.A.
Boston University School of Medicine
Boston, Massachusetts
Boston University, Biology
Boston, Massachusetts
May 1999
May 1995
--~'1C5~ib~~*~-B~~~
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i .
Assistant Professor of University of Miami I July 2004 _ Present
Medicine Mount Sinai Medical Center
Fellow in Geriatrics &.
. Gerontology
Weill Medical College of
Cornell University
New York, New York
July 2002 - June 2004
Clinical Fellow in
Medicine
New York Presbyterian Hospital
New York, New York
July 2002 - June 2004
Residency in
Internal M ed ici ne
RUSH Presbyterian
S1. Luke's Medical Cent~r
Chicago, Illinois .
July 1999 - June 2002
(r r:r~ I
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License in IL # 36 J I J 420
License in FL # 91884
DEA in FL /I BL 9013309
USMLE J
USMLE II
USMLE III
Internal Medicine - Certified
Geriatrics (CAQ - anticipated)
June 1997
August 1998
May 2000
August 2002
Novem ber 2003
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I have been successfully involved with the
development of the Division's chronic
disease module for medical students,
physicians' approach to the chronically ill
and the psychosocial impact of chronic
disease
Work accomplished to date includes:
- A systematic review of the literature
- Developing an educational intervention:
- Observed Subjective Clinical
Examination (OSeE)
- A n educational assessment tool
f .. i ;1- :
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Created and presented problem based learning cases and other educational materials for house
staff
Panicipated in a weekly three-hour geriatric educational seminar and a monthly research
methodology seminar
Developed expertise with rehabilitation, use of assistive devices, and home safety evaluation
Attained expertise in a wide range of geriatric syndromes and diseases
Acquired proficiency in managing polyphannacy and identifying drug.drug interactions
Worked col/egial/y in an interdisciplinary team as a member and as a leader
Delivered expert care to nursing home residents at a medical. rehab, ventilator, and dementia units
Developed eXpertise in providing care to home-bound individuals including hospice patients
Acquired proficiency in the treatment of depression, anxiety, dementia. and dementia with
agitation
Demonstrated skills in managing preSSure ulcers, venous ulcers, and surgical' WOunds
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Content
,
Audience
Functional assessment &
approach to the geriatric pt.
Internal medicine residents
and medical students
Hypertension & Orthostatic
hypotension in the elderly
Rehab PT & or
Hypertension in the elderly
Journal Club
Division's Fellow yearly
presentation
Osteoporosis
Physician assistant students
Rehabilitation residents
Dementia & Urinary
incontinence
. .
Th ird year medical students
during primary care clerkShip.
Introduction to chronic ill
individuals
First year medical students
during the COurse "Medicine,
Patients and Soc iety"
"Living with Chronic Disease- Greenberg Academy for
Diabetes and its Successful Aging- older
complications" adults education program
Date
September 2002 (monthly)
March 2003
April 2003 .
May 2003 (yearly)
December 2003
December 2003 (quarterly)
March 2004
April 2004
ImDD~A~ON~'~.~~l~~~iB.;;~~.'t:i~~4,';:'~!'~F=~rr;f:,ft-!m'4ir~~~fT~~7'~;~~~ls~pr4".c~rr~..~~ ..
~ -....~!1.~~;.t:i1it"1!' .', .' ....~:~~~:..~..::lEf~~.....,.J,~,rJ;.~1~.i~~~~~:lJ~~l:2J!o&lMt::~
Increased Calcium Influx Following Thapsigargin Treatment in Aplysia Bag Cells Neurons.
Levy S., Levine A. Biophys. J. 1994;66:) 48 .
Increased Thapsigargin- Mediated Calcium Uptake in Clusten of Aplysia Bag Cell Neuron.
Levy S., Utheza D., and Levine A. Biophys. J. ) 996;70:322A
Utility of EMU in the Relief or Pain Associated with Electroneurography. Amiel Levine, L.
Clarke Cox, C. Bruce MacDonald. Journal of American Academy oj Audi%gy. 9:41-46,1998
Chronic Disease Education: Literature Review. Levin AmieJ, Division of Geriatrics and
Gerontology, Weill Medical College of Come II University, New York, NY. Abstract for AGS,
Las Vegas, May 2004. Submitted.
Chronic Disease Education: The Challenge of Stimulating Students to Care. March 2004.
Levin Amiel, C.F. Capello, R. Breckman, V.M. LoFaso. Division of Geriatrics and Gerontology,
Weill Medical College orComell University, New York, NY. Abstract for AGS, Las Vegas, May
2004. Submitted.
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American College of Physicians
American Geriatrics Society
Gerontological Society of America
Metropolitan Association Gerialric Specialist
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Created and presented problem based learning cases and other educational materials for house
staff
Panicipated in a weekly three-hour geriatric educa'tional seminar and a monthly research
methodology seminar
Developed expenise with rehabilitation, use of ass istive devices, and home safety evaluation
Attained expenise in a wide range of geriatric syndromes and diseases
Acquired proficiency in managing polyphannacy and identifying drug-drug interactions
Worked coIJegially in an interdisciplinary team as a member and as a leader
Delivered expen care to nursing home residents al a medical, rehab, ventilator, and dementia units
Developed expenise in providing care to home-bound individuals including hospice patients
Acquired proficiency in the treatment of depression, anxiety, dementia, and dementia with
agitation
Demonstrated skills in managing pressure ulcers, venous ulcers, and surgical wounds
._~.._.".~~~. !.iII'?::~'C~~".',."",;s._~~ ~
: fI(., .;. . ...~. . ~~..,;i'it.~~.~. ".'-.1:";;: .... ~~~;ra;~:~"l.f:;.1{i..i..: . : 'N'..~') . ..:' .~.. ....
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Content
I
Functional assessment &
approach to the geriatric pt.
Hypertension & Orthostatic
hypotension in the elderly
Hypertension in the elderly
Journal Club
Osteoporosi 5
Dementia & Urinary
incontinence
Introduction to chronic ill
individuals
"living with Chronic Disease-
Diabetes and its
complications"
Audience
Internal medicine residents
and medical students
Rehab PT & OT
Division's Fellow yearly
presentation
Physician assistant students
Rehabilitation residents
. .
Third year medical students
during primary care clerkship.
First year medical students
during the COurse "Medicine,
Patients and Society"
Greenberg Academy for
Successful Aging- older
adults education program
Date
September 2002 (monthly)
March 2003
April 2003
May 2003 (yearly)
December 2003
December 2003 (quarterly)
March 2004
Apri I 2004
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--.0_....- ;..... .....;..l.o:......."I;,,;.A.:'...._.,._I~...:....__._""'_.__._ . _____"'-;;. .... .~.
Increased Calcium Inllux Following Thapsigargin Treatment in Aplysia Bag Cells Neurons.
Levy S., Levine A. Biophys. J. J994;66: J48 .
Iucreased Thapsigargin_ Mediated Calcium Uptake in Clusters of Aplysia Bag Cell Neuron.
levy S., Utheza D., and Levine A. Biophys. J. 1996;70:322A
Utility of EM LA in the Relief of Pain Associated with Elec:lroneurography. Amiel Levine, L.
Clarke Cox, C. Bruce MacDonald. Journal of American Academy of Audiology. 9:41-46.1998
Cbronic Disease Education: Literature Review. Levin Amiel, Division of Geriatrics and
Gerontology, Weill Medical COllege of Cornell University, New York, NY. Abstract for AGS,
Las Vegas, May 2004. Submined.
Cbronic Disease Education: The Challenge of Stimulating Students to CaR. Marcb 2004.
Levin Am iel.. C.F. Capello, R. Breckman, V.M. LoFaso. Division of Geriatrics and Gerontology,
. Weill Medical College of Cornell University, New York. NY. Abstract for AGS, Las Vegas, May
2004. Submined.
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Gerontological Society of America
Metropolitan Association Geriatric Specialist
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DEARfGISTAAnON
NUWBfR
THIS IIfGISrAAflON FE.!
fXPIAU PAID
Bl.013309
03.:11-2007.:.,.' Paid
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lEVIN, AMIELMD">;i";::' . .> ,.' ."",
MOUNT SINAI MEDICAL CENT~R':;"
OUTPATIENT DePARTMENT.":.fr:>
.300 ALTON ROAD :.:..:':"".,;:;"...
MIAMI BEACH, FL 33140
CONTROLLED SUBSTANCE RECISTAATION CERTIFICATe
UNITED STATES DEPARTMENT OF JUSTICE
DRUG ENFORCEMENT ADMINISTRATION
~S"INCTON. D.C. 20537
S,cUonI JOol IIId 1001 (21 U.S.C. '24 Ind IS') ollila
COnltOlled SW.lancll Act 01 1870. ., Ilnended provide
rhlt 11'1. AlloIne, G.".,., ma, '.vall. Of IUSpend a
II'glllralian fa m.nur.CIlMer. O'InDuIe. di,pen... inlpott at
..~ · concralleCllUllsrlnC..
THIS CERTIFICATE'S NOT TllANSFfRA8Lf ON CHANGE OF
OWNERSH". CONTROL. LOCAnON. IUSINfSSACrlVllY. OR
VALID AFT!" THE EJuI'RAr'ON DATE.
Form DEA.223 (05104,
------------------------------------------------
I
CONTROLLED SUBSTANCE REGISTAATION CERTIFICATE
UNITED STATES DEPARTMENT OF JUSTICE
DRUG ENFORCEMENT ADMINISTRATION
WASHINGTON, D.C. 20537
DEA A[CIS"'-'TIOH
NU".flt
THIS "feISTRAnON
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LEVIN, AMIEL Me
MOUNT SINAI MEDICAL CENTER
OUTPAnENTDEPARTMENT
4300 ALTON ROAD
MIAMI BEACH, FL 33140 ....
ThiS CERnFICATE IS NOT TAANSFEAAIILE ON CHANGE OF OWNERSHIp, CONTROL. LOCATION, BUSINESSACTIVITV, OR VALID
AFTER ThE EXPlAATION DATE , ,. .
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JEB BUSH
GOVERNOR OF FLORIDA
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JOHN O. AGWUN081. M.D.. M.P.H.. M.BA.
SECRETARY. DEPARTMENT OF HeALTH
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Boston University
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Office of the Registrar
715 AJbany Sueet
Boston, Musach usctts
021 J8.2526
Tel: 6J 7 638-4J6O
fax: 6J 7 638.4J55
E.mail: edifiorc@bu.edu
Ellen J. DiFiore
Registrar
(jJOS'ItY.N'lJtNI'VEllS/TY'S !MOO/CAr. SClfOOr.
'11ie Cou1lCIT atuf 'Trustees tif (jJoston Vniversity. in t/ie Commonweaftli tif
!Ma.r.racliusetts. greeti1llJs to all 'WIiom tliis tfocument reac/ies.
Sina AMIEL LEVIN , erufowea witli oootf a6ility .
ana alSti1llJuis/ietf 6y uprialit cliar,actn; lias applietf liimse(f to t/ie requiretf studies in t/ie
scfioor tif !Mearane tif t/ie Vniversity, ana tlirouali rigorous qaminatwns set 6y
intfivUfuaf professors lias proven liimse(f well trainetf in t/ie)lrt tif !Mealdne ana t/ie
Sciences pertaini1llJ to it, t/ierefore we t/ie professors tif t/ie afonsaitf scfioor liave tfecUktf
in consensus to 6estow upon liim t/ie aeoree tif f/Joctor tif !Meareine, ana to orant Iii", all
t/ie insiania, rialits, lionors, ana privifeoes pertaini1llJ to tliis tfeoree lien aruf efsew/iere.
/ n testimony tliereoJ" t/ie sear tif t/ie Vniversity lias ken afJVc!tf to tliis dOcument
on t/ie 23RD dO) of. MAY in tlie year 1999 .JUD., ana t/ie
??'lRn year tif tIie fJtepu6lic. (jJy autlioniy entrustetf to us we liave su6scnoetf our
names.
(Jlram ~ Cfio6anian)
([)tE}f!J{
(Jon Westfino)
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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DaYY)
01/31/2005
PRODUCER 345-949-7988 THIS CERTIFICATE IS ISSUED AS A'MATTER OF INFORMATION o Nt. Y AND
MARSH MANAGEMENT SERVICES CAYMAN LTD. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
P.O. BOX 1051 GT POLICIES BELOW,
tv> FLOOR. FIRSTCARIBBEAN HOUSE COMPANES AFFORDING COVERAGE
GEORGE TOWN. GRAND CAYMAN COMPANY MCl..NT SINt\1 MEDICA. CENTER Cf
CAYMAN ISLANDS, B.W.I. A FlCRIDA G.JffiPNTEE CCRR:RATlO\J
INSl.fiEO COMPANY
Mount Sinai Medical Center of Ftorida, Inc. a
4300 Alton Road COMPANY
Miami Beach. FL 33140 C
COMPANY
0
COVERAGES
THIS IS TO CERTIFY THAT THE POlICIES OF INSURANCE USTED BElON HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSUPANCE AFFORDED BY THE PQJCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONCHICtIlS OF
SUCH POUCIES. UMI IS SHONN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE Of INSURANCE POlICY NUMBER POLICY EFfEcrlVE POLICY E)(PtRAJlON L1MJIS
UR DATE -Ob(,M M/Dl)Yy) DA TE .Ob(MMlOONv)
GENERAl LIABIlJTV . SIR OENERALAGGREGATE $
;--.
COMMERCIAL OEN:RAL LIABIUTY PRODUCTS. COMP/OP AGO $
n CLAIMS MADE DOCCUR PERSO~L&ArN.I~URY $
OWJl.ER'S & CONTRACTOR'S PROT EACH OCCURRE~E S
fo-
FIRE DAMAGE (All{ one Ore) S
fo-
MED. EXPENSE (Ant one person) S
AUTOMOBILE L1AWLlIY
f-- COMSIN:D SINGLE UMIT S
ANY AlIrO
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ALL OWNED AIJTOS BODILY IN.lJR'(
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SCHEDu..ED AUTOS /Per person) S
r-
HIRED AUTOS
- SODIL Y IN.lJR'i
NON-DWN:D AUTOS (Per Kelda.-) S
'"'-
-
PROPERTY DAMAGE . S
GARAGE LIABILIIY AUTO ONLY -EA ACCIDENT $
-
ANY AUTO OTHER THAN AlIrO ONLY:
-
EACH ACCIDENT S
~
AGGREOA TE I
A EJC:ESS LIABlLIIY EACH OCCURRENCE $ S 000 000
g~MBREUAFORM MSMCFGC-PR-A-05 02/01105 02101/06 AGOREGATE I S.OOO 000
X OTHER THAN UMBREUA FORM I
,wc STATU. I I~TH
lM>RKER'S COMPENSA TIONAND EMPlOYER'S TuRY UMITS ER
LIABILI-TY
EACH ACCIDENT $
TtE PROPRlETORl R:r~L DISEASE-POLICY UMIT I
PARTNERS/EX ECUTWE DISEASE-EACH EMPLOYEE
OfFICERS ARE: EXCL I
OTHER
CLAIMS MADE PROFESSIONAL SIR S5.ooo.000
A LIABILITY IS IN EXCESS OF SELF
INSURED RETENTION
DESCRIPTIONS Of OPERATIONSilOCAJlOHSfVEHICLESISA:ClAl IIEMS
INSURED: AMIEL LEVIN, lvID. RETRO DATE: 09-NOV-04.
CERTIFICA TE HOLDER CANCELlA TION
SHOu..O ANY OF THE ABOVE oeSCRlBEe POUCIES !:IE CA~ELLED BEFORE THE
EXPIRA TION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO M.4.IL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER MillED TO THE LEFT.
MOWlt Sin:i Medical Center of Florida, Inc. BUT FAIL~E TO MAIL SUCH NOTICE S~LL IMPOSE t{) OaJGATlON OR
LIABILITY OF Atlt ,qt.{) UPON TIi: COMPANY, ITS AGENTS OR
4300 Alton Road REPRESENTA TIVES
Miami Be~h. FL 33140 AUTHORIZED REPRESENTATI\A:
Mount Sinai
MEDICAL CENTER
LOCATION & HOURS
Address:
Mount Sinai Medical Center
4300 Alton Road, Lowenstein Building, 1 st Floor
Miami Beach, FL 33140
Location:
The Lowenstein Building is located on the North end of the campus.
The entrance to the Occupational Health Center is located on the South side of
the Lowenstein Building.
Free Parkina:
Lowenstein Parking lot located directly in front of the Lowenstein Building
Hours of operation:
Monday through Friday: 7:00 a.m. to 5:00 p.m.
Saturdays: Half day, only on request
Hours are flexible
Mount Sinai Medical Center - Emeraency Department
24-hours, 7 days a week (urine collection for drug testing and alcohol screening
for breath alcohol testing)
See Floor Plan Attached
Attachment B
Page 9
Attachment B
Mount Sinai Medical Center
Occupational Health Center Floor Plan
MOUNT SINAI MEDICAL CENTER
4300 ALTON ROAD
MIAMI BEACH, FL 33140
Attachment B
NEW OCCUPATIONAL HEALTH FACILITY
FLOOR PLAN
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Mount Sinai
MEDICAL CENTER
PROPOSER'S EXPERIENCE AND PAST PERFORMANCE
Mount Sinai Medical Center opened its doors in 1946 and has been serving the
community for over 55 years. Mount Sinai Medical Center currently has
approximately a 935-licensed bed capacity providing acute care, a full
compliment of diagnostic and treatment facility throughout Dade County with its
main campus in Miami Beach.
Bay Harbor Islands Police Department
Contact Person: Assistant Chief Duncan Young
Telephone No. 305-866-6242
Worked Performed: Pre-employment and Annual Physicals and
Drug Screening
City of Hialeah
Contact Person: Capitan Felix Perez
Telephone No. 305-883-6900
Worked Performed: Fire Fighters Hazmat Physicals
City of Miami Beach/CMB Housing
Contact Person: Kathryn Esteves
Telephone No. 305-532-6401
Worked Performed: Drug Screening
City of North Bay Village
Contact Person: Chief Irving Heller
Telephone No. 305-756-7171
Worked Performed: Pre-employment and Annual Physicals, City including Police
and Drug Screening
Comprehensive Health Services
Contact Person: Beverley Archer
Telephone No. 1-800-638-8083
Worked Performed: Pre-employment and Annual Physicals and Drug Screening
Dade County Public Schools-Special Investigative Unit
Contact Person: Sabrina Cromartie
Telephone No. 305-757-7708
Work Performed: Pre-employment and Annual Police Physicals
Page 10
Ecology& Environment, Inc.
Contact Person: Paul Jonmaire
Telephone No. 716-684-8060
Worked Performed: Pre-employment and Annual Physicals and
Drug Screening
EI Portal Police Department
Contact Person: Ronnie Hufnagel
Telephone No. 305-795-7880
Work Performed: Police Annual and Drug Screening
Intercredit Bank
Contact Person: Sylvia Coutinho
Telephone No. 305-375-8442
Work Performed: Drug Screening
Key Biscayne Police and Fire Department
Contact Person: Chief Shawn Evans
Telephone No. 305-365-8989
Work Performed: Pre-employment and Annual Physicals and
Drug Screening
Lloyds Bank
Contact Person: Carol Ann Loo
Telephone No. 305-579-8905
Work Performed: Drug Screening
Medley Police Department
Contact Person: Ruben Rubiera
Telephone No. 305-883-2047
Work Performed: Pre-employment Police Physical and Drug Screening
Miami-Dade County
Contact Person: Michael Edwards
Telephone No. 305-375-2643
Work Performed: Pre-employment and Annual Physicals
OSHA, Exposures, Drug Screening, including DOT
Miami Parking Systems
Contact Person: Socorro. Perez
Telephone No. 305-373-6789
Work Performed: Standard Pre-employment and Drug Screening
Page 11
Salick Comprehensive Center
Contact Person: Carmen Sabagh
Telephone No. 305-534-9460
Work Performed: Pre-Employment and Exposures
South Miami Police Department
Contact Person: Chief Michael Mills
Telephone No. 305-663-6301
Work Performed: Pre-employment and Annual Physicals and Drug Screening
Sunrise Fire Department
Contact Person: Chief James Dixon
Telephone No. 954-746-3400
Work Performed: Hazmat Physicals
WPLG-CHANNEL 10
Contact Person: Kathy Salazar
Telephone No. 325-2303
Work Performed: Pre-employment Physicals and Drug Screening
Affiliated Physicians
Contact person: Zulma Vazquez
Telephone No. (212)935-8725
Worked Performed: Pre-employment and Annual Physical
Aramark Clinical Engineering
Contact person: Dennis Vanderheyden
Telephone No.(305)674-2961
Worked Performed: Labs & Vaccine
City of Opa-Locka
Contact person: Wiston Mottley
Telephone No.(305)953-2900
Worked Performed: Annual Physical
Consulate of Japan
Contact person: Dr. Takayuki Koike
Telephone No.(305)530-9090
Worked Performed: Annual Physical
GRM
Contact person: Omela. Lee
Telephone No.(201 )798-4710
Worked Performed: Drug Screening
Page 12
Mount Sinai Credit Union
Contact person: Anne Vale
Telephone No. (305)674-3009
Worked Performed: Drug Screening
Ressler,Hirschl and Lelchuk
Contact person: Dr. Hirschi
Telephone No. (305)532-1444
Worked Performed: Labs & Vaccine
Special Care Unit
Contact person: Lisa Masaya
Telephone No. (305)674-6020
Worked Performed: Drug Screening & Labs.
T. Y. Un International
Contact person: Colin Henderson
Telephone No. (305)567-1888
Worked Performed: Annual Physical
Village of Pinecrest
Contact person: Peter Lombardi
Telephone No. (305)234-2121
Worked Performed: Annual Physical & Standard Physical
Vitas
Contact person: Bryan Payne
Telephone No. (954)704-2088
Worked Performed: Pre-employment
Page 13