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Florida <br /> Medical October 7, 2013 <br /> Clinic <br /> To Whom It May Concern: <br /> BOARD OF DIRECTORS <br /> PAUL HUGMES,M.U.,J.D <br /> President This is to ive Dixie Si ns Inc. ernussion to obtain Permits and erect sign(s) <br /> AAARK EISMER,M.D g g � p <br /> s��e�ary lacated at: 36801 Eiland Blvd.Zephyrhills, FL 33542 <br /> CHANDRESH SARAIYA,M.D. <br /> Treosurer <br /> DAViD SIKES,M.o. Property ID# 36801 Eiland Blvd, Zebhyrhills, FL 33542 <br /> Yte President <br /> BARRY FRANK,M.D. OWIleCI bY: FMC Eiland. LLC <br /> Vice President Owners address: 38135 Market S uare,Ze hvrhills. 33542 <br /> EMILIO DOMINGUEZ,M.D. q p - <br /> Chief Med'ecal Officer <br /> IRA GUTTENTAG,M.D. <br /> Yce President <br /> REYNALDO MUUNGTAPANG,M.D. S1T1CeT'CIy� <br /> Member-At-lorge Joe Delatorr CE'� <br /> 10E DEWTORRE <br /> Cfiief Executrve Officer <br /> COLLEEN CUFFE � � <br /> Chief Operoting OH�cer Name: <br /> CMRIS ALVARE2 <br /> Chiaf f�nanciol Officer /� � <br /> GUS TAYLOR Title: C <br /> Chief Admrnistratrve Offrcer <br /> Date: 1 a ZQ 13 <br /> STATE OF FLORIDA, COUNTY OF PASCO. <br /> The foregoing instrument was acknowledged before me this 1 h day <br /> of �C_�'(:���� r , — <br /> 20 13 , by _ �c��. 1�e��� . r f t_ , who is ersp onal� <br /> known to me or who had produced <br /> as identification and who did take an oath. <br /> �NM�u sou�o <br /> n,, �� Noa�r vwNe•uw a�. <br /> �1.1'Yl�_,�,;-. ' w caaw.EqM��r t�.�o�e <br /> CanaNnbn#ff 19��00 <br /> Notary Public <br /> My commission expires: <br /> (Printed, typed or stamped—commissioned name of notary) <br /> ANESTHFSIOIflGY • ALIERGY/IMMUNOLOGY • AUDIOLOGV / HEARING AID$ � BREAST SURGERY • CARDIOtOGY • DERMATOIOGY <br /> ENDOCRINOLOGV • FACIAL PLASTIC SURGERY • fAMIIY MEOICINE • GASTROENTEROLOGY • GENERAI SURGERY <br /> HEMATOLOGY/MEDICAL ONCOLOGY • HOSPITAL MEDICINE • INfECT10US DISEASES • OBSTETRICS/GYNECOLOGY <br /> iNTERNAL MEDICINE • INTERYENTIONAt PAIN MANAGEMENT • NEPHROLOGY • NEUROIOGY • <)PHTHAIMOLdGY <br /> UNCOLOGY SURGERY � pRIHOPAEpICS � OTULARYNGOLOGV • PATHOLpGY • PRUCTOIOGV • PSYCHIA7RY • PULMONOIOGV <br /> RAOfOIOGV • RHEUMATOIOGY • SIEEP OISORDERS • SPINE SURGERY • UROIOGV • vASCULAR SURGERY <br /> 3 8 1 3 5 M A R K E T 5 Q U A R E Z E P H Y R H i L l S , F L O R i D A 3 3 5 4 2 8 1 3 7 8 0 8 4 4 0 <br />