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STATE AGENCY ACTION REPORT ON APPLICATION FOR CERTIFICATE OF NEED.PROJECT IDENTIFICATION1. Applicant/CON Action Number Florida International Medical Center, LLC/CON #10476 955 NW 3rd Street Miami,
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Step 1: Start by obtaining the necessary form for the Florida International Medical Center.
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Step 2: Fill in your personal information, including your name, date of birth, and contact details.
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Step 3: Provide your medical history, including any pre-existing conditions, allergies, and current medications.
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Step 4: Include information about your insurance provider, policy number, and any relevant medical coverage.
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Step 6: Review the completed form to ensure all sections are filled out accurately and completely.
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Step 7: Sign and date the form to certify that the information provided is true and accurate.
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Step 8: Submit the filled-out form to the appropriate department or office at the Florida International Medical Center.

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Florida International Medical Center is a state-of-the-art medical facility located in Florida.
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