STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

' f?" - !j• ...

lLt.U

/>.HCA

,i\GENCY CLERK

2012 MAY 22 A 8: 50

vs.

Petitioner,

CASE NO.: 11-1328MPI C.I. No.: 11-2590-000

Provider No.: 308510400

CLAYTON SAXOUR, CRNA,

Respondent.

                                                                   I

FINAL ORDER

THE Respondent filed a Withdrawal of Request for Formal Hearing on April 14, 2011

based on the Agency's rescission letter dated April 11, 2011. On April 15, 2011, the Division of Administrative Hearings closed its file. Based on the foregoing, this file is CLOSED.

DONE and ORDERED on this the .i.l!!!'Siay of         , 2012, m Tallahassee, Florida.

Agency for Health Care Administration

1

Filed May 22, 2012 4:08 PM Division of Administrative Hearings

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BYLAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.

Copies furnished to:

Andrew Sheeran, Esquire Agency for Health Care Administration (Interoffice Mail)

Todd Cranshaw Cranshaw Brown

481 North US Highway One Ormond Beach, FL 32174 (U.S. Mail)

Lawrence P Stevenson Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

Mike Blackbum, Chief, Medicaid Program Integrity Finance and Accounting

HQA

Department of Health (Individual)

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to

the above named addressees by U.S. Mail on this the..&of

v , 2012.

/  

file

Agency Clerk State of Florida

Agency for Health Care Administration 2727 Mahan Drive, Building #3

Tallahassee, Florida 32308-5403

(850) 412-3630

Docket for Case No: 11-001328MPI

Orders for Case No: 11-001328MPI