1997 DIRECTORY OF MANAGED CARE PROVIDERS (FLORIDA)

Preferred Health Network
301 E. Ocean Blvd., Suite 900, Long Beach, Calif. 90802; 562-983-1616; fax: 562-436-4389
Staff/Facilities
Primary practitioners5,136
Specialists13,683
Hospitals115
Users: Group Health
Employer/payer groups597
Employees & dependents192,637
Users: Workers Compensation
Employer/payer groups5
Total Users*192,637
Operational date: April 1990.
Service area: Florida: 58 counties.
Services: General medical, vision, mental health, workers compensation, auto carrier liability, Medicare Select.
**Figure does not include workers comp.
See Preferred Health Network consolidated listing under California.
Principal Health Care Inc.-PPO, Jacksonville Division
1200 Riverplace Blvd., Suite 500, Jacksonville, Fla. 32207; 904-390-0935; fax: 904-399-2176
Staff/Facilities
Primary practitioners471
Board-certified78.3%
Patients/practitioner26
Specialists1,304
Hospitals18
Users: Group Health
Employer/payer groups10
Employees & dependents13,483
Total Users13,483
Operational date: December 1989.
Service area: Florida: Alachua, Baker, Clay, Columbia, Duval, Nassau and St. John's counties.
UR: Preadmission review, precertification, concurrent review and length of stay determination. UR provided by outside contractors and by payer.
Officers: Kenneth J. Linde, president/CEO; Robert Mrizek, vp/counsel; Sharon Taylor, David Weiss, vps.
Contact: Robin Talkington, 301-581-0600.
See Principal Health Care Inc.-PPO consolidated listing under Maryland.
Principal Health Care Inc.-PPO, Orlando Division
2300 Maitland Center Parkway, Suite 317, Orlando, Fla. 32751; 407-667-8800; fax: 407-667-8883
Staff/Facilities
Primary practitioners476
Board-certified100%
Specialists1,152
Hospitals20
Users: Group Health
Employer/payer groups5
Employees & dependents14,094
Total Users14,094
Operational date: April 1992.
Service area: Florida: Lake, Orange, Osceola, Seminole and Volusia counties.
Officers: Kenneth J. Linde, president/CEO; Dr. Donald Levene, medical director; Dan Mulkey, director-marketing; Bob Mrizek, vp/counsel; Sharon Taylor, vp-operations; David Weiss, vp-planning/development.
Contact: Leslie G. Robinson, director-health operations.
See Principal Health Care Inc.-PPO consolidated listing under Maryland.
Principal Health Care Inc.-PPO, South Florida Division
9130 S. Dadeland Blvd., Suite 1116, Miami, Fla. 33156; 305-670-9244; fax: 305-670-9243
Staff/Facilities
Primary practitioners1,053
Board-certified80%
Specialists2,800
Hospitals44
Users: Group Health
Employer/payer groups5
Employees & dependents16,082
Total Users16,082
Operational date: May 1992.
Service area: Florida: Broward, Dade and Palm Beach counties.
Officers: Kenneth J. Linde, president/CEO; Dr. Donald Levene, medical director; Dan Mulkey, director-marketing; Bob Mrizek, vp/counsel; Sharon Taylor, vp-operations; David Weiss, vp-planning/development.
Contact: Leslie G. Robinson, director-health operations.
See Principal Health Care Inc.-PPO consolidated listing under Maryland.
Principal Health Care Inc.-PPO, Tampa Divison
4350 W. Cypress St., Tampa, Fla. 33607; 813-877-4630; fax: 813-877-2148
Staff/Facilities
Primary practitioners945
Board-certified50%
Specialists3,575
Hospitals32
Users: Group Health
Employer/payer groups6
Employees & dependents37,950
Total Users37,950
Operational date: May 1991.
Service area: Florida: Charlotte, Citrus, Collier, Hernando, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk and Sarasota counties.
Officers: Kenneth J. Linde, president/CEO; Dr. Donald Levene, medical director; Dan Mulkey, director-marketing; Bob Mrizek, vp/counsel; Sharon Taylor, vp-operations; David Weiss, vp-planning/development.
Contact: Leslie G. Robinson, director-health operations.
See Principal Health Care Inc.-PPO consolidated listing under Maryland.
Private Healthcare Systems
1511 N.W. Shore Boulevard, Suite 620, Tampa, Fla. 33607; 813-282-8200; fax: 813-282-8210
Staff/Facilities
Primary practitioners5,502
Board-certified84%
Specialists7,767
Hospitals93
Pharmacies2,570
Users: Group Health
Employees & dependents107,838
Total Users107,838
Operational date: April 1985.
Service area: Florida: 25 cities and Brevard County.
See Private Healthcare Systems PPO consolidated listing under Massachusetts.
Private Healthcare Systems Inc.
1511 Northwest Shore Blvd., Suite 620, Tampa, Fla. 33607; 813-285-7427;
fax: 813-282-8210
Staff/Facilities
Primary practitioners2,607
Board-certified84%
Specialists7,767
Hospitals93
Pharmacies2,570
Users
Employees & dependents4,776
Total4,776Service Area: Florida: 32 cities.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
ProAmerica Managed Care
1250 E. Copeland Road, Arlington, Texas 76011; 800-523-3669; fax: 817-436-5391
Staff/Facilities
Primary practitioners3,668
Specialists9,116
Hospitals81
Users: Group Health
Employees & dependents47,000
Total Users47,000
Service area: Florida: statewide.
See ProAmerica Managed Care consolidated listing under Texas.
Prudential HealthCare HMO-Central Florida
2301 Lucien Way, Suite 230, Orlando, Fla. 32751; 407-875-6600; fax: 407-661-6830
Staff/Facilities
Primary practitioners529
Board-certified81%
Specialists1,250
Hospitals19
Pharmacies9
Primary care locations57
Users
Single coverage6,889
Family coverage7,557
Employees & dependents135,742
Medicare9,262
Total145,004Operational date: April 1984.
Licensed in: Florida.
NCQA fully accredited.
Model type: IPA.
Service area: Florida: Brevard, Flagler, Indian River, Lake, Marion Orange, Osceola, Polk, Seminole and Volusia counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Offers self-insured products.
Point-of-service contracts: 29% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Andrew Crooks, executive director; Darlene Burton, marketing director; Kathy Marshall, provider relations; Dr. Ross Edmunsen, medical director; Tina Jackowski, case management.
See Prudential HealthCare HMO consolidated listing under New Jersey.
Prudential HealthCare HMO-Jacksonville
1200 Riverplace Blvd., Suite 701, Jacksonville, Fla. 32207; 904-345-5800; fax: 904-346-5888
Staff/Facilities
Primary practitioners258
Board-certified74%
Specialists734
Hospitals7
Pharmacies90
Primary care locations10
Users
Single coverage18,700
Family coverage21,279
Employees & dependents90,648
Medicare8,490
Total99,138Operational date: August 1984.
Federally qualified.
Licensed in: Florida.
NCQA fully accredited.
Model type: Group/IPA.
Service area: Florida: Baker, Clay, Duval, Nassau and St. Johns counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Point-of-service contracts: 6% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Andrew Crooks, executive director; Marcia King, marketing director; Vicki Miller, provider relations; Dr. James Clower, medical director; Susan Evans, case management.
Contact: Marcia C. King.
See Prudential HealthCare HMO consolidated listing under New Jersey.
Prudential HealthCare HMO-South Florida
5900 N. Andrews Ave., Suite One, Fort Lauderdale, Fla. 33309; 954-492-8244; fax: 954-771-0542
Staff/Facilities
Primary practitioners764
Board-certified83%
Specialists1,796
Hospitals37
Pharmacies157
Primary care locations71
Users
Single coverage33,454
Family coverage27,095
Employees & dependents128,603
Medicare17,629
Total146,232Operational date: October 1986.
Federally qualified.
Licensed in: Florida.
NCQA fully accredited.
Model type: IPA.
Service area: Florida: Broward, Dade and Palm Beach counties.
Services: General medical, dental, vision, prescription drug, mental health, substance abuse, convalescent nursing home, home health, hospice, lab. Services available unbundled.
Point-of-service contracts: 33% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Amy Knapp, executive director; Bill Condon, marketing director; Ozzie Bloom, provider director; Dr. Jonathan Gavras, medical director; Beth Galt-Salsamendi, case management.
Contact: Bill Condon, 954-492-8244.
See Prudential HealthCare HMO consolidated listing under New Jersey.
Prudential HealthCare HMO-Tampa Bay
3450 W. Busch Blvd., Suite 245, Tampa, Fla. 33618; 813-932-1977; fax: 813-288-0080
Staff/Facilities
Primary practitioners476
Board-certified77%
Specialists1,260
Hospitals13
Pharmacies204
Primary care locations26
Users
Single coverage19,987
Family coverage29,954
Employees & dependents71,683
Medicare17,947
Total89,630Operational date: July 1985.
Federally qualified.
Licensed in: Florida.
NCQA fully accredited.
Model type: Mixed.
Service area: Florida: Hernando, Hillsborough, Pasco and Pinellas counties.
Services: General medical, dental, vision, prescription drug, mental health, substance abuse. Services available unbundled*.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Michael Subasic, executive director; Darlene M. Burton, marketing director; J.C. Carter, provider relations; Dr. Thomas Wyatt, medical director; Jackie Wallace, case management.
Contact: Darlene Burton, 813-288-0800.
*General medical and dental only.
See Prudential HealthCare consolidated listing under New Jersey.
Prudential HealthCare POS-Central Florida
2301 Lucien Way, Suite 230, Orlando, Fla. 32751; 407-875-6600; fax: 407-661-6830
Staff/Facilities
Primary practitioners529
Board-certified81%
Specialists1,250
Hospitals19
Pharmacies9
Primary care locations57
Users
Single coverage11,812
Family coverage14,400
Employees & dependents56,649
Total56,649Operational date: July 1986.
Licensed in: Florida.
NCQA fully accredited.
Model type: IPA.
Service area: Florida: Brevard, Flagler, Indian River, Lake, Marion, Orange, Osceola, Polk, Seminole and Volusia counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Offers self-insured products.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Andrew Crooks, executive director; Darlene Burton, marketing director; Kathy Marshall, provider relations; Dr. Ross Edmunsen, medical director; Tina Jackowski, case management.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Jacksonville
1200 River Place Blvd., Suite 701, Jacksonville, Fla. 32207; 904-345-5800; fax: 904-346-5888
Staff/Facilities
Primary practitioners258
Board-certified74%
Specialists734
Hospitals7
Pharmacies90
Primary care locations10
Users
Single coverage18,700
Family coverage21,279
Employees & dependents90,648
Medicare8,490
Total99,138Operational date: September 1986.
Licensed in: Florida.
NCQA fully accredited.
Model type: Group/IPA.
Service area: Florida: Baker, Clay, Duval, Nassau and St. Johns counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Andrew Crooks, executive director; Marcia King, marketing director; Vicki Miller, provider relations; Dr. James Clower, medical director; Susan Evans, case management.
Contact: Marcia C. King.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-South Florida
5900 N. Andrews Ave., Suite One, Fort Lauderdale, Fla. 33309; 954-492-8244; fax: 954-771-0542
Staff/Facilities
Primary practitioners764
Board-certified88%
Specialists1,798
Hospitals36
Pharmacies157
Primary care locations69
Users
Single coverage9,399
Family coverage9,777
Employees & dependents39,535
Medicare16,435
Total55,970Operational date: May 1986.
Licensed in: Florida.
NCQA fully accredited.
Model type: IPA.
Service area: Florida: Broward, Dade and Palm Beach counties.
Services: General medical, dental, vision, prescription drug, mental health, convalescent nursing home, home health hospice, laboratory, substance abuse. Services available unbundled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Amy Knapp, executive director; Bill Condon, marketing director; Ozzie Bloom, provider director; Dr. Jonathan Gavras, medical director; Beth Galt-Salsamendi, case management.
Contact: Bill Condon, 954-492-8244.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Tampa Bay
3450 W. Busch Blvd., Suite 245, Tampa, Fla. 33618; 813-932-1977; fax: 813-288-0080
Staff/Facilities
Primary practitioners497
Board-certified77%
Specialists1,496
Hospitals15
Pharmacies204
Primary care locations34
Users
Single coverage3,872
Family coverage3,694
Employees & dependents14,969
Total14,969Operational date: January 1986.
Licensed in: Florida.
NCQA one year accredited.
Model type: Group/IPA.
Service area: Florida: Hernando, Hillsborough, Pasco and Pinellas counties.
Services: General medical, dental, vision, prescription drug, mental health, substance abuse. Services available unbundled*.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Michael Subasic, executive director; Darlene M. Burton, marketing director; J.C. Carter, provider relations; Dr. Thomas Wyatt, medical director; Jackie Wallace, case management.
Contact: Darlene Burton, 813-288-0800.
*General medical and dental only.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare PPO-Central Florida
2301 Lucien Way, Suite 230, Orlando, Fla. 32751; 407-875-6600; fax: 407-661-6830
Staff/Facilities
Primary practitioners263
Board-certified85%
Specialists551
Hospitals14
Pharmacies9
Operational date: January 1989.
Service area: Florida: Brevard, Flagler, Indian River, Lake, Marion, Orange, Osceola, Polk, Seminole and Volusia counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Precertification, concurrent review, discharge planning, case management. UR provided by the PPO.
Officers: Andrew Crooks, executive director; Darlene M. Burton, marketing director; Kathy Marshall, provider relations; Dr. Ross Edmundsen, medical director.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-Jacksonville
1200 Riverplace Blvd., Suite 701, Jacksonville, Fla. 32207; 904-345-5800; fax: 904-346-5888
Staff/Facilities
Primary practitioners163
Board-certified79%
Specialists457
Hospitals4
Operational date: July 1991.
Service area: Florida: Baker, Clay, Duval, Nassau and St. Johns counties.
Officers: Andrew Crooks, executive director; Marcia King, marketing director; Vicki Miller, provider relations; Dr. James Clower, medical director.
Contact: Marcia King, 904-346-5802.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-South Florida
5900 N. Andrews Ave., Suite 1000, Fort Lauderdale, Fla. 33309; 954-492-8244; fax: 954-771-0542
Staff/Facilities
Primary practitioners983
Board-certified75%
Specialists2,308
Hospitals35
Pharmacies157
Operational date: January 1987.
Service area: Florida: Broward, Dade and Palm Beach counties.
Services: General medical, prescription drug, convalescent nursing home, home health, hospice. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by discount off customary rates; is compensated by employers/payers; charges by percent of services by doctors/hospitals.
UR: Standard procedures, excluding outpatient service predetermination. UR provided by the PPO.
Officers: Amy Knapp, executive director; Bill Condon, marketing director; Ozzie Bloom, provider relations; Dr. Jonathan Gavras, medical director.
Contact: Bill Condon.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-Tampa Bay
3450 W. Busch Blvd., Suite 245, Tampa, Fla. 33618; 813-932-1977; 813-288-0080
Staff/Facilities
Primary practitioners 494
Board-certified77%
Specialists1458
Hospitals6
Pharmacies204
Operational date: January 1986.
Service area: Florida: Hernando, Hillsborough, Pasco and Pinellas counties.
Services: General medical, dental, vision, prescription drug, mental health, substance abuse. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures, excluding outpatient service predetermination. UR provided by the PPO.
Officers: Michael Subasic, executive director; Darlene M. Burton, marketing director; J.C. Carter, provider relations; Dr. Thomas Wyatt, medical director.
Contact: Darlene Burton, 813-288-0800.
See Prudential HealthCare PPO consolidated listing under New Jersey.