Preview
AFFIDAVIT OF SERVICE
STATE OF FLORIDA COUNTY OF CHARLOTTE, 20TH JUDICIAL CIRCUIT
CASE NO.: 00-120 CA
CIRCUIT COURT
Mark Aspirilla, M.D.,
Sally Simon, as Personal Representative
Of the Estate of Michael Simon vs. Mark Aspirilla, M.D., P.A., et al.,
efendants
Plaintiff
eed
Fogleman & Rosenkoetter, P.A.
FOR:
3400 South Tamiami Trail, Suite 302
Sarasota, Florida 34239
Received by James R. Ickes, on March 20, 2000, at 11:45 a.m. to be served on: sey
#
or me
Medical Records Custodian for Charlotte Chiropractic Clinic PS-
2
4065 Tamiami Trail, Port Charlotte, Florida
I, James R. Ickes, who, being duly sworn, depose and say that on March 23, 2000, at 6:00 p.m.), I executed service by delivering a
true copy of the:
Subpoena Duces Tecum Without Deposition
with the date and hour of service endorsed thereon by me, in accordance with state statutes in the following manner:
0) Individual Service: Served the above-named person at the above listed address or at:
(XX) Substitute Service: By serving__Sandy York, Office Manager, == _
who is 18 years of age or older
as
() Corporate Service: By serving
() Other Service: As described in the Comments below by serving
Charlotte County Clerk
C1078167 Date : 03/28/00 - 15:03:00 id: 20
Case#: 00000120CA Pages: 0003
() NON-SERVED, see comments below
I certify that | am over the age of 18, have no interest in the above action, and have proper authority in the jurisdiction in which this service
was made.
Sworn to and subscribed before me this Bot day of 2 4 4
March » 2000 by James R. Ickes, who is
personally known to me or has produced a Florida drivers license as R. ICKES, Process Server
xO. Box 510126
Punta Gorda, Florida 33951-0126
identification.
as a. FI??: Zohar (941) 575-4632
12* Judicial Circuit Certification #0169
‘NOTARY PUBLIC
Charlotte County Appointment #6
Lisa M. Tarhune
MY COMMISSION # CC706870 EXPIRES
Janvary
BONDED THRU TROV FAWN INSURANCE NcIN THE CIRCUIT COURT OF THE 20 JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA
SALLY SIMON, as Personal Representative
of the Estate of Michael Simon,
Plaintiff,
vs. Case No. 00-120 CA
MARK ASPIRILLA, M.D., MARK ASPIRILLA, M.D,
P.A., a Florida Corporation, DALE GREENGERG, M.D.
RONALD CONSTINE, M.D., LEVY, BAKER, CONSTINE
& GREENBERG, M.D., P.A., a Florida Corporation,
SAMUEL ESTEPA, M.D., PRIMARY CARE PHYSICIANS,
INC., a Florida Corporation, TOMAS K. WASZNY, M_D.,
TOMAS K. WASZNY, M.D., P.A., a Florida Corporation,
BALA K. NANDIGAM, M.D., CHARLOTTE MEDICAL
ASSOCIATES, P.A., a Florida Corporation, MOODEN
MOOPEN., M.D., MOIDEN MOOPEN, M.D., P.A., a
Florida Corporation, CARLOS E. MAAS, M.D.,
oO
CARLOS E. MAAS, M.D., P.A., a Florida Corporation, x, ny
NASIR KHALIDI, M.D., NASIR KHALIDI & SAKINA “ P r
Ie
S¢
KHALIDI, M.D., P.A. a Florida Corporation, ST. JOSEPHS be R.
EMERGENCY MEDICAL PHYSICIANS, a Florida Corporation,
FRANK COLUNGA, M.D., CHRIS MICKELSON, M.D., e?? Lb
Defendants. ve ae
BPI T DEP!
THE STATE OF FLORIDA:
TO: Medical Records Custodian for
Charlotte Chiropractic Clinic
4065 Tamiami Trail
Port Charlotte, Florida
YOU ARE COMMANDED to appear at 3400 S. Tamiami Trail, Ste. 302 in
Sarasota, Florida, on Friday, April 14, 2000 at 10:00 a.m., and to have with you at that
time and place the following:
1. Any and all medical documents, including patient charts, copies of any
writing or markings on the folders containing the patient charts, previous treating
physician's records, phone log records, appointment book records, e-mail,
computer records or orders, photographs, photograph negatives, x-ray films,
scans, tracings, request slips and radiology reports in your possession, custodyor control concerning the medical diagnosis, prognosis, care or treatment of
Michael Simon, DOB: 05/25/42, SSN No:
2. Any and all documents in your possession, custody or control concerning
charges and payments for the medical care and treatment of Michael Simon.
These items will be inspected and may be copied at that time. You will not be
required to surrender the original items. You may comply with this subpoena by
condition the preparation of the copies upon the payment in advance of the reasonable
cost of preparation. You may mail or deliver the copies to the attorneys whose name
is subpoena and thers liminate your a ran
specified above. You have the right to object to the production pursuant to this
subpoena at any time before production by giving written notice to the attorneys whose
name appears on this subpoena.
If you fail to:
(1) appear as specified; or
(2) furnish the records instead of appearing as provided above; or
(3) object to this subpoena, you may be in contempt of court. You are
subpoenaed by the attorneys whose names appear on this
subpoena and unless excused from this subpoena by the attorneys
or the Court, you shall respond to this subpoena as directed.
DATED on § 1 1989S 2200
BARBARA SCOTT
As Clerk Hy Sour
By: La
Claudia Rosenkoetter
Fla. Bar No: 311073
FOGLEMAN & ROSENKOETTER, P.A.
3400 S. Tamiami Trail, Suite 302
Sarasota, Florida 34239
(941) 365-4400
Attorney for Defendants Nandigam and
Charlotte Medical Associates, P.A.
Preview
AFFIDAVIT OF SERVICE STATE OF FLORIDA COUNTY OF CHARLOTTE, 20TH JUDICIAL CIRCUIT CASE NO.: 00-120 CA CIRCUIT COURT Mark Aspirilla, M.D., Sally Simon, as Personal Representative Of the Estate of Michael Simon vs. Mark Aspirilla, M.D., P.A., et al., efendants Plaintiff eed Fogleman & Rosenkoetter, P.A. FOR: 3400 South Tamiami Trail, Suite 302 Sarasota, Florida 34239 Received by James R. Ickes, on March 20, 2000, at 11:45 a.m. to be served on: sey # or me Medical Records Custodian for Charlotte Chiropractic Clinic PS- 2 4065 Tamiami Trail, Port Charlotte, Florida I, James R. Ickes, who, being duly sworn, depose and say that on March 23, 2000, at 6:00 p.m.), I executed service by delivering a true copy of the: Subpoena Duces Tecum Without Deposition with the date and hour of service endorsed thereon by me, in accordance with state statutes in the following manner: 0) Individual Service: Served the above-named person at the above listed address or at: (XX) Substitute Service: By serving__Sandy York, Office Manager, == _ who is 18 years of age or older as () Corporate Service: By serving () Other Service: As described in the Comments below by serving Charlotte County Clerk C1078167 Date : 03/28/00 - 15:03:00 id: 20 Case#: 00000120CA Pages: 0003 () NON-SERVED, see comments below I certify that | am over the age of 18, have no interest in the above action, and have proper authority in the jurisdiction in which this service was made. Sworn to and subscribed before me this Bot day of 2 4 4 March » 2000 by James R. Ickes, who is personally known to me or has produced a Florida drivers license as R. ICKES, Process Server xO. Box 510126 Punta Gorda, Florida 33951-0126 identification. as a. FI??: Zohar (941) 575-4632 12* Judicial Circuit Certification #0169 ‘NOTARY PUBLIC Charlotte County Appointment #6 Lisa M. Tarhune MY COMMISSION # CC706870 EXPIRES Janvary BONDED THRU TROV FAWN INSURANCE NcIN THE CIRCUIT COURT OF THE 20 JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA SALLY SIMON, as Personal Representative of the Estate of Michael Simon, Plaintiff, vs. Case No. 00-120 CA MARK ASPIRILLA, M.D., MARK ASPIRILLA, M.D, P.A., a Florida Corporation, DALE GREENGERG, M.D. RONALD CONSTINE, M.D., LEVY, BAKER, CONSTINE & GREENBERG, M.D., P.A., a Florida Corporation, SAMUEL ESTEPA, M.D., PRIMARY CARE PHYSICIANS, INC., a Florida Corporation, TOMAS K. WASZNY, M_D., TOMAS K. WASZNY, M.D., P.A., a Florida Corporation, BALA K. NANDIGAM, M.D., CHARLOTTE MEDICAL ASSOCIATES, P.A., a Florida Corporation, MOODEN MOOPEN., M.D., MOIDEN MOOPEN, M.D., P.A., a Florida Corporation, CARLOS E. MAAS, M.D., oO CARLOS E. MAAS, M.D., P.A., a Florida Corporation, x, ny NASIR KHALIDI, M.D., NASIR KHALIDI & SAKINA “ P r Ie S¢ KHALIDI, M.D., P.A. a Florida Corporation, ST. JOSEPHS be R. EMERGENCY MEDICAL PHYSICIANS, a Florida Corporation, FRANK COLUNGA, M.D., CHRIS MICKELSON, M.D., e?? Lb Defendants. ve ae BPI T DEP! THE STATE OF FLORIDA: TO: Medical Records Custodian for Charlotte Chiropractic Clinic 4065 Tamiami Trail Port Charlotte, Florida YOU ARE COMMANDED to appear at 3400 S. Tamiami Trail, Ste. 302 in Sarasota, Florida, on Friday, April 14, 2000 at 10:00 a.m., and to have with you at that time and place the following: 1. Any and all medical documents, including patient charts, copies of any writing or markings on the folders containing the patient charts, previous treating physician's records, phone log records, appointment book records, e-mail, computer records or orders, photographs, photograph negatives, x-ray films, scans, tracings, request slips and radiology reports in your possession, custodyor control concerning the medical diagnosis, prognosis, care or treatment of Michael Simon, DOB: 05/25/42, SSN No: 2. Any and all documents in your possession, custody or control concerning charges and payments for the medical care and treatment of Michael Simon. These items will be inspected and may be copied at that time. You will not be required to surrender the original items. You may comply with this subpoena by condition the preparation of the copies upon the payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to the attorneys whose name is subpoena and thers liminate your a ran specified above. You have the right to object to the production pursuant to this subpoena at any time before production by giving written notice to the attorneys whose name appears on this subpoena. If you fail to: (1) appear as specified; or (2) furnish the records instead of appearing as provided above; or (3) object to this subpoena, you may be in contempt of court. You are subpoenaed by the attorneys whose names appear on this subpoena and unless excused from this subpoena by the attorneys or the Court, you shall respond to this subpoena as directed. DATED on § 1 1989S 2200 BARBARA SCOTT As Clerk Hy Sour By: La Claudia Rosenkoetter Fla. Bar No: 311073 FOGLEMAN & ROSENKOETTER, P.A. 3400 S. Tamiami Trail, Suite 302 Sarasota, Florida 34239 (941) 365-4400 Attorney for Defendants Nandigam and Charlotte Medical Associates, P.A.