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Filing # 127933829 E-Filed 06/02/2021 11:30:12 AM
IN THE CIRCUIT COURT, EIGHTH
JUDICIAL CIRCUIT, IN AND FOR
ALACHUA COUNTY, FLORIDA
DYLAN T. CONE,
Plaintiff, CASE NO: — 2021-CA-000039
vs.
EVAN R. HORNBUCKLE and
ANNESSA S. FREDERICK,
Defendants.
DEFENDANT’S CERTIFICATE OF COUNSEL OF NON-OBJECTION
TO: Records Custodians for:
CVS Pharmacy
c/o C T Corporation System
1200 S. Pine Island Rd.
Plantation, FL 33324
Phone: 800-287-2414 x 3
Publix Pharmacy
3300 Publix Corp Pkwy.
Lakeland, FL 33811
Phone: 863-688-1188 x 56348
Walgreens Pharmacy
c/o Prentice Hall Corp System
1202 N. Hays St., Ste. 105
Tallahassee, FL 32301
Walmart Pharmacy / Walmart CT Corporation
c/o C T Corporation System
1200 S. Pine Island Rd.
Plantation, FL 33324
Phone: 479-204-6788
Medical Injury Group (MEDIG)
Page 1 of 4
"2021 CA 000039" 127933829 Filed at Alachua County Clerk 06/02/2021 11:30:16 AM EDT4410 Newberry Rd.
Gainesville, FL 32607
Phone: 352-374-2818 Fax: 352-376-4094
UF Health Shands Hospital
Attn: HIM, Radiology, & Billing
P.O. Box 100345
Gainesville, FL 32610
Phone: 352-594-0909 Fax: 352-627-4500
UF Health Physician Clinics (ALL CLINICS)
PO Box 100354
Gainesville, FL 32610
Phone: 352-594-0909 Fax: 352-265-1098
Titan MRI
919 NW 57" St., Ste. 20
Gainesville, FL 32605
Phone: 352-672-6644 Fax: 352-672-6103
State Farm Mutual Automobile Insurance Company
c/o Chief Financial Officer
Service of Process Section
200 E. Gaines St.
Tallahassee, FL 32399
Phone: 800-732-5246
Nationwide Mutual Insurance Company (Health Insurance)
c/o Chief Financial Officer
Service of Process Section
200 E. Gaines St.
Tallahassee, FL 32399
Phone: 614-249-1545
Nationwide Mutual Insurance Company (Employment)
c/o Chief Financial Officer
Service of Process Section
200 E. Gaines St.
Tallahassee, FL 32399
Phone: 614-249-1545
UF Health Orthopaedics & Sports Medicine
3450 Hull Rd.
Gainesville, FL 32607
Phone: 352-273-7001 Fax: 352-627-4418
Page 2 of 4Frank A. Orlando Jr., MD
200 SW 62nd Blvd., Ste. D
Gainesville, FL 32607
Phone: 352-265-9475
St. Petersburg General Hospital
HIM Share Services - Centralized Release of Information, Radiology, & Billing
6451 126th Ave. N.
Largo, FL 33773
Phone: 866-463-7272, 727-384-1414 Fax: 855-446-6008
Johns Hopkins All Children’s Hospital
Attn: Release of Information, Dept. #6500002401, Radiology, & Billing
PO Box 31020
St. Petersburg, FL 33731-8920
Phone: 727-767-7048 Fax: 727-767-8312
Community Health Centers of Pinellas, Inc. (ALL LOCATIONS)
7550 43rd St. North
Pinellas Park, FL 33781
Phone: 727-544-2284 Fax: 727-541-7984
Winn-Dixie Stores, Inc.
c/o Corporation Service Company
1201 Hays St.
Tallahassee, FL 32301
Circle K Stores Inc. d/b/a Kangaroo
c/o Corporation Service Company
1201 Hays St.
Tallahassee, FL 32301
Progressive Insurance
c/o Corporate Creations Network Inc.
801 US Hwy 1
N Palm Beach, FL 33408
Phone: 855-347-3939
COMES NOW, Defendants, EVAN R. HORNBUCKLE and ANNESSA S.
FREDERICK, by and through undersigned counsel and pursuant to Florida Rules of Civil
Procedure 1.351, states that a Notice of Production from Non-Party was served upon counsel for
Page 3 of 4the Plaintiff under a certificate of service dated May 14, 2021 and Plaintiff is aware that these
records have been requested and have waived objections to the production of the records delineated
in the attached non-party subpoena directed to you.
This information is being disclosed in the course of a lawsuit filed by the Plaintiff. This
Certificate of Non-Objection complies with 45 CFR §164.512 (HIPPA) and Rule 1.351(c), Florida
Rules of Civil Procedure.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished
VIA EMAIL to David Carlson, Esq.: ALLEN LAW FIRM, P.A., 2550 SW 76" Street, Suite
150, Gainesville, FL 32608, litigation@allenlaw.com; melissa@allenlaw.com;
david@allenlaw.com this 2nd day of June 2021.
BRETT LITTLE, P.A.
/s/ Brett Little
Brett Little, Esq.
Primary E-Mail: legalteam@brettlittlepa.com
Post Office Box 142410
Gainesville, FL 32614
(352) 363-6494
Florida Bar No.: 233780
Attorney for Defendants
Page 4 of 4
Preview
Filing # 127933829 E-Filed 06/02/2021 11:30:12 AM IN THE CIRCUIT COURT, EIGHTH JUDICIAL CIRCUIT, IN AND FOR ALACHUA COUNTY, FLORIDA DYLAN T. CONE, Plaintiff, CASE NO: — 2021-CA-000039 vs. EVAN R. HORNBUCKLE and ANNESSA S. FREDERICK, Defendants. DEFENDANT’S CERTIFICATE OF COUNSEL OF NON-OBJECTION TO: Records Custodians for: CVS Pharmacy c/o C T Corporation System 1200 S. Pine Island Rd. Plantation, FL 33324 Phone: 800-287-2414 x 3 Publix Pharmacy 3300 Publix Corp Pkwy. Lakeland, FL 33811 Phone: 863-688-1188 x 56348 Walgreens Pharmacy c/o Prentice Hall Corp System 1202 N. Hays St., Ste. 105 Tallahassee, FL 32301 Walmart Pharmacy / Walmart CT Corporation c/o C T Corporation System 1200 S. Pine Island Rd. Plantation, FL 33324 Phone: 479-204-6788 Medical Injury Group (MEDIG) Page 1 of 4 "2021 CA 000039" 127933829 Filed at Alachua County Clerk 06/02/2021 11:30:16 AM EDT4410 Newberry Rd. Gainesville, FL 32607 Phone: 352-374-2818 Fax: 352-376-4094 UF Health Shands Hospital Attn: HIM, Radiology, & Billing P.O. Box 100345 Gainesville, FL 32610 Phone: 352-594-0909 Fax: 352-627-4500 UF Health Physician Clinics (ALL CLINICS) PO Box 100354 Gainesville, FL 32610 Phone: 352-594-0909 Fax: 352-265-1098 Titan MRI 919 NW 57" St., Ste. 20 Gainesville, FL 32605 Phone: 352-672-6644 Fax: 352-672-6103 State Farm Mutual Automobile Insurance Company c/o Chief Financial Officer Service of Process Section 200 E. Gaines St. Tallahassee, FL 32399 Phone: 800-732-5246 Nationwide Mutual Insurance Company (Health Insurance) c/o Chief Financial Officer Service of Process Section 200 E. Gaines St. Tallahassee, FL 32399 Phone: 614-249-1545 Nationwide Mutual Insurance Company (Employment) c/o Chief Financial Officer Service of Process Section 200 E. Gaines St. Tallahassee, FL 32399 Phone: 614-249-1545 UF Health Orthopaedics & Sports Medicine 3450 Hull Rd. Gainesville, FL 32607 Phone: 352-273-7001 Fax: 352-627-4418 Page 2 of 4Frank A. Orlando Jr., MD 200 SW 62nd Blvd., Ste. D Gainesville, FL 32607 Phone: 352-265-9475 St. Petersburg General Hospital HIM Share Services - Centralized Release of Information, Radiology, & Billing 6451 126th Ave. N. Largo, FL 33773 Phone: 866-463-7272, 727-384-1414 Fax: 855-446-6008 Johns Hopkins All Children’s Hospital Attn: Release of Information, Dept. #6500002401, Radiology, & Billing PO Box 31020 St. Petersburg, FL 33731-8920 Phone: 727-767-7048 Fax: 727-767-8312 Community Health Centers of Pinellas, Inc. (ALL LOCATIONS) 7550 43rd St. North Pinellas Park, FL 33781 Phone: 727-544-2284 Fax: 727-541-7984 Winn-Dixie Stores, Inc. c/o Corporation Service Company 1201 Hays St. Tallahassee, FL 32301 Circle K Stores Inc. d/b/a Kangaroo c/o Corporation Service Company 1201 Hays St. Tallahassee, FL 32301 Progressive Insurance c/o Corporate Creations Network Inc. 801 US Hwy 1 N Palm Beach, FL 33408 Phone: 855-347-3939 COMES NOW, Defendants, EVAN R. HORNBUCKLE and ANNESSA S. FREDERICK, by and through undersigned counsel and pursuant to Florida Rules of Civil Procedure 1.351, states that a Notice of Production from Non-Party was served upon counsel for Page 3 of 4the Plaintiff under a certificate of service dated May 14, 2021 and Plaintiff is aware that these records have been requested and have waived objections to the production of the records delineated in the attached non-party subpoena directed to you. This information is being disclosed in the course of a lawsuit filed by the Plaintiff. This Certificate of Non-Objection complies with 45 CFR §164.512 (HIPPA) and Rule 1.351(c), Florida Rules of Civil Procedure. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished VIA EMAIL to David Carlson, Esq.: ALLEN LAW FIRM, P.A., 2550 SW 76" Street, Suite 150, Gainesville, FL 32608, litigation@allenlaw.com; melissa@allenlaw.com; david@allenlaw.com this 2nd day of June 2021. BRETT LITTLE, P.A. /s/ Brett Little Brett Little, Esq. Primary E-Mail: legalteam@brettlittlepa.com Post Office Box 142410 Gainesville, FL 32614 (352) 363-6494 Florida Bar No.: 233780 Attorney for Defendants Page 4 of 4