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        <BusinessNameLine1>SOUTH FLORIDA PALLIATIVE MEDICINE</BusinessNameLine1>
        <BusinessNameLine2>SPECIALISTSINC</BusinessNameLine2>
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        <AddressLine2>Suite</AddressLine2>
        <City>WEST PALM BEACH</City>
        <State>FL</State>
        <ZIPCode>33407</ZIPCode>
      </USAddress>
    </Filer>
    <Officer>
      <Name>DAVID FIELDING</Name>
      <Title>PRESIDENT</Title>
      <Phone>5618407800</Phone>
      <DateSigned>2014-02-15</DateSigned>
      <AuthorizeThirdParty>true</AuthorizeThirdParty>
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    <Preparer>
      <Phone>3128997000</Phone>
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    <TaxYear>2012</TaxYear>
    <BuildTS>2016-03-07 17:11:31Z</BuildTS>
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        <PersonName>THOMAS TRACY</PersonName>
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