2013-05-09T12:32:13-05:00 2012-06-30 PURVIS GRAY & COMPANY LLP 443 EAST COLLEGE AVENUE TALLAHASSEE FL 32301 990 2011-07-01 571234883 FLORIDA MEDICAL PRACTICE PLAN INC FLOR 8506452827 1115 WEST CALL STREET TALLAHASSEE FL 32306 JOHN P FOGARTY MD 8506452827 2013-05-08 true RYAN M TUCKER CPA 8502247144 2013-05-08 2011 2016-02-25 16:41:14Z JOHN P FOGARTY 1115 WEST CALL STREET TALLAHASSEE FL 32306 9372249 false X WWW.MED.FSU.EDU/FMPP X 2006 FL THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. 9 0 0 0 0 8709858 9366824 4022 5425 0 8713880 9372249 50000 5500 0 6119246 6680566 0 0 1996515 2172103 8165761 8858169 548119 514080 2341360 3212259 935335 1292154 1406025 1920105 X THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. false false 8819898 5500 9369400 PERFORMED PROFESSIONAL SERVICES IN SUPPORT OF: 1)AFFILIATION AGREEMENTS WITH HOSPITALS FOR GRADUATE MEDICAL EDUCATION PROGRAMS, AND 2) AGREEMENTS WITH HEALTH DEPARTMENTS, CLINICS, AND OTHERS FOR PATIENT CARE. 8819898 true false false false false false false false false false false false false false true false true true false false true false false false false false false true false true false false false false false false false false false false false false false true true true false false true 5 0 0 false false false false false false X 9 0 true false false false false false false true true false false true true true true true true true true false X DAWN SNYDER 8506452827 1115 WEST CALL STREET TALLAHASSEE FL 32306 X JOHN P FOGARTY MD 1.00 X X 0 375059 47879 JOHN R CARNAGHI MED 1.00 X 0 283455 44409 RICARDO GONZALEZ-ROTHI MD 1.00 X 0 273575 59893 ALMA B LITTLES MD 1.00 X X 0 261605 59783 ROBERT BRADLEY PHD 0.00 X 0 251485 28287 DANIEL J VAN DURME MD 1.00 X X 0 243958 39172 KENNETH V BRUMMEL-SMITH MD 1.00 X 0 243049 38291 RICHARD S NOWAKOWSKI PHD 1.00 X 0 230819 32169 JANINE EDWARDS PHD 1.00 X 0 198234 66789 GARNETT S STOKES PHD 0.50 X 0 131784 21815 LAWRENCE G ABELE PHD 0.00 X 0 294508 83814 2787531 522301 true true false FSU COLLEGE OF MEDICINE SELF INSURAN 1115 W CALL STREET TALLAHASSEE FL 32306 SELF INSURANCE 449648 BLUE CROSS BLUE SHIELD OF FLORIDA PO BOX 44144 JACKSONVILLE FL 32231 HEALTH INSURANC 235242 DIVISION OF STATE GROUP INSURANCE PO BOX 5450 TALLAHASSEE FL 32314 HEALTH INSURANC 109795 3 CLINICAL REVENUE 624100 9109003 9109003 MEDICAID REVENUE 624100 257821 257821 9366824 5425 5425 9372249 9366824 5425 5500 5500 6134763 6134763 269825 269825 41994 41994 233984 233984 377983 377983 21355 21355 160571 160571 3525 3525 13391 13391 33539 33539 1061103 1061103 MEDICAL SUPPLIES 429973 429973 TRAINING 24170 24170 PROGRAM FEES 23355 23355 LICENSURE 8747 8747 14391 14391 8858169 8819898 38271 0 1168180 1567878 925384 1455648 109410 40810 138386 147923 2341360 3212259 51840 70681 883495 1221473 935335 1292154 X 1406025 1920105 1406025 1920105 2341360 3212259 514080 X false true true X false X X X X false false false FLORIDA STATE UNIVERSITY 591961248 2 true true true 7093853 1 7093853 false false false false false false false false false false FLORIDA STATE UNIVERSITY AUXILIARY 1221473 1221473 9372249 8858169 514080 514080 9372249 9372249 9372249 8858169 8858169 8858169 false CENTRAL AMERICA AND THE CARIBBEAN PROGRAM SERVICE MEDICAL MISSION TRIP 12396 12396 12396 CENTRAL AMERICA AND THE CARIBBEAN 12,396 0 false FLORIDA STATE UNIVERSITY FOUNDATION INNOVATION PARK 2010 LEVY AVENUE TALLAHASSEE FL 32306 596152180 501 5500 CONTRIBUTION 1 X X X X false false false false false false false false false JOHN P FOGARTY MD 375059 20507 27372 422938 JOHN R CARNAGHI MED 274383 3000 6072 25466 18943 327864 RICARDO GONZALEZ-ROTHI MD 273575 21331 38562 333468 ALMA B LITTLES MD 259105 2500 21498 38285 321388 ROBERT BRADLEY PHD 211832 1100 38553 20864 7423 279772 DANIEL J VAN DURME MD 243958 22613 16559 283130 KENNETH V BRUMMEL-SMITH MD 240549 2500 21732 16559 281340 RICHARD S NOWAKOWSKI PHD 228319 2500 21229 10940 262988 JANINE EDWARDS PHD 198234 18460 48329 265023 GARNETT S STOKES PHD 129284 2500 10257 11558 153599 LAWRENCE G ABELE PHD 294508 23542 60272 378322 ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. ADDITIONAL INFORMATION FORM 990 FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES: THE FLORIDA MEDICAL PRACTICE PLAN, INC. DOES NOT HAVE EMPLOYEES. THE SALARIES AND BENEFITS REPORTED ON THE STATEMENT OF FUNCTIONAL EXPENSES ARE SALARIES AND BENEFITS REIMBURSED TO FLORIDA STATE UNIVERSITY. OTHER REIMBURSEMENTS TO FLORIDA STATE UNIVERSITY INCLUDE MANAGEMENT FEES AND INSURANCE EXPENSES. RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 ROBERT B. BRADLEY, PH.D. GARNETT S. STOKES, PH.D. DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER ROBERT B. BRADLEY, PH.D. JOHN R. CARNAGHI, M.ED. DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER GARNETT S. STOKES, PH.D. JOHN R. CARNAGHI, M.ED. DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER JOHN P. FOGARTY, M.D. ALMA B. LITTLES, M.D. DIRECTOR DIRECTOR ON AMA COUNCIL TOGETHER ALMA B. LITTLES, M.D. JOHN P. FOGARTY, M.D. DIRECTOR DIRECTOR ON FAFP BOARD TOGETHER ALMA B. LITTLES, M.D. ROBERT B. BRADLEY, PH.D. DIRECTOR DIRECTOR ON FSU ATHLETIC BOARD TOGETHER ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE FINAL FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THROUGH ELECTRONIC MAIL PRIOR TO SUBMITTAL TO THE INTERNAL REVENUE SERVICE. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANY DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, IS COVERED UNDER THE POLICY. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE DIRECTORS, AND THE DIRECTORS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A MEMBER FAILS TO DISCLOSE A CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE ORGANIZATION'S TOP OFFICIAL IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION FOR THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII EACH BOARD MEMBER SPENDS AT LEAST 40 HOURS A WEEK DEVOTED TO FLORIDA STATE UNIVERSITY BUSINESS. FLORIDA STATE UNIVERSITY A2201 UNIVERSITY CENTER TALLAHASSEE FL 32306 591961248 UNIVERSITY FL 501C3 2 N/A false false false false false false false false false false false false false true true true false false false FLORIDA STATE UNIVERSITY O 6894148 CASH FLORIDA STATE UNIVERSITY M 199705 CASH