Case Number: COCE-20-023924 Division: 50
`Filing # 113549886 E-Filed 09/17/2020 04:07:34 PM
`
`ALIGN YOUR SPINE CHIROPRACTIC IN THE COUNTY COURTIN AND
`LIFE CENTER,INC.
`FOR BROWARD COUNTY, FLORIDA
`a/a/o Zahava Merlis
`
`CASE NO.:
`
`Plaintiff,
`
`VS.
`
`ALLSTATE FIRE AND CASUALTY
`INSURANCE COMPANY
`
`Defendant
`
`
`COMPLAINT
`
`COMES NOW,Plaintiff, ALIGN YOUR SPINE CHIROPRACTIC LIFE
`CENTER, INC. a/a/o Zahava Merlis (hereinafter “Plaintiff’) sues the Defendant,
`ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY(hereinafter
`“Defendant”), and in support thereof alleges the following:
`
`GENERAL ALLEGATIONS
`
`This is an action for Breach of Contract, which does exceed One
`1.
`Hundred Dollars ($100.00), but does not exceed Five Hundred Dollars ($500.00),
`exclusive of interest, attorney’s fees and costs.
`
`Defendant was and remains a corporation organized and existing
`2.
`underthe lawsof the State of Florida and is otherwise suijuris.
`
`Defendant was and is a corporation authorized to do business,
`3.
`maintains an office and agents in BROWARD COUNTY andregularly sells
`automobile insurance policies to the general public in BROWARD COUNTY.The
`Defendant and/or its affiliates and/or its subsidiaries which issued the policy of
`insurance have substantial identities of interest.
`
`Atall times material hereto, Plaintiff was a corporation duly licensed
`4.
`to perform medical services in the State of Florida.
`
`11, 2018, Zahava Merlis
`On or about November
`5.
`“Claimant’) was involved in a motor vehicle accident.
`
`(hereinafter
`
`*#* FTLED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 09/17/2020 04:07:31 PM.****
`
`

`

`Asaresult of that motor vehicle accident, Plaintiff provided Claimant
`6.
`with medical services and/or treatment.
`
`As a direct and proximate result of the injuries sustained by Claimant
`7.
`in the accident, Claimant incurred reasonable expenses for necessary medical and
`rehabilitative care by the Plaintiff for an Emergency Medical Condition as
`evidenced by the Claimant’s entire medical record. To date, Defendant refuses to
`pay the full amount due.
`
`issued a policy of insurance to Elaina Merlis which
`Defendant
`8.
`provided personal injury protection benefits coverage required by law to comply
`with Florida Statutes Sections 627.730 thru 627.7405. Plaintiff does not have a
`copy of the policy to attach; however, Plaintiff believes that the Defendant has a
`copy of said policy. Upon receipt of a certified copy of the insurance policy, same
`is hereby attached and incorporated herein by reference.
`
`The above described policy was in full force and effect on the date of
`9.
`the accident and provided PIP coverage for Zahava Merlis for bodily injuries
`sustained in said accident.
`
`Plaintiff and Claimant have performed the statutorily required
`10.
`conditions precedent to entitle Plaintiff to recover benefits for said necessary
`medical,
`rehabilitative and remedial
`treatment regarding the above-described
`policy and statutory conditions precedentto instituting this action.
`
`Claimant equitably assigned to Plaintiff and/or also executed a written
`11.
`assignment of benefits, assigning to Plaintiff certain benefits payable pursuant to
`the policy of insurance issued by Defendant.
`
`Pursuant to said Assignment, Plaintiff gave notice of the covered
`12
`losses and Plaintiff made demand for PIP benefits for reasonable, necessary and
`related medical treatment.
`
`13. Defendant has denied coverage for, withheld or reduced the medical
`bill(s) that were submitted by Plaintiff for date(s) of service November 15, 2018
`through March 04, 2019 and/or misapplied the application of the deductible.
`Furthermore, Defendant was precluded from applying a deductible at all because
`the nonexistence of a properly executed deductible election form. A copy of the
`HCFA bills and/or patient
`ledger and/or explanation of benefits/review are
`attached hereto and incorporated by reference. Due to the failure of Defendant to
`pay these PIP benefits in accordance with the law, Plaintiff has been required to
`retain the undersigned law firm to act on their behalf in this suit. Plaintiff has
`
`[405-00106/32935064/1]
`
`

`

`agreed to pay, and the attorneys for Plaintiff have agreed to accept, any court
`awardedfee.
`
`BREACH OF CONTRACT FOR FAILURE TO PAY AMOUNTS OWED.
`
`14.
`complaint.
`
`Plaintiff reavers and realleges paragraphs
`
`1
`
`through 13 of this
`
`15. Despite prior demand by Plaintiff, Defendant has refused and
`continues to refuse to issue payment of all sums due Plaintiff,
`in violation of
`Section 627.736, Florida Statutes, and in breach of its contact with claimant.
`
`Plaintiff has retained the undersigned firms to represent it
`16.
`action and has agreed to pay a reasonable fee for said services.
`
`in this
`
`Pursuant to Section 627.428, Florida Statutes, Plaintiff is entitled to
`17.
`recover from Defendant reasonable attorney’s fees and costs for the necessity of
`this action.
`
`WHEREFORE,Plaintiff requests:
`
`a.
`
`b.
`
`C.
`
`d.
`
`e.
`
`f.
`
`this Honorable Court declare that Defendant
`That
`paymentofall sums due to Plaintiff;
`
`is overdue in
`
`That Defendant pay all sums due to Plaintiff under Claimant’s policy
`of Insurance with Defendant;
`
`That Defendant pay interest on all unpaid sums in accordance with
`Section 627.736(4), Florida Statutes;
`
`That Defendant pay Plaintiff pre-suit penalty, postage, and interest in
`accordance with Section 627.736(10), Florida Statutes.
`
`That the Defendant correctly apply the deductible “to 100 percent of
`the expenses and losses”as described in Fla. Stat. 627.736,if
`applicable;
`
`That The Defendants pay all sums dueto Plaintiff under any medical
`payment’s (med-pay) coverage’s in accordance with the
`Claimant’s/policy holder’s policy of Insurance with Defendant;
`
`[405-00106/32935064/1]
`
`

`

`g.
`
`That Defendant pay Plaintiff reasonable attorney’s fees and costs
`pursuant to Sections 627.428, Florida Statutes, and/or 627.736(5),
`Florida Statutes, for the necessity of this action;
`
`h.
`
`Anyotherrelief this Court deems just and appropriate.
`
`injury
`for personal
`WHEREFORE, Plaintiff demands judgment
`protection benefits together with pre-judgment interest, costs and attorneys’ fees
`pursuant to Florida Statute 627.428 and Florida Statute sections 627.736(5) and
`(8) and any otherrelief this Court deems properandjust.
`
`Plaintiff demandstrial by jury on all issues triableas ofright.
`
`LANDAU & ASSOCIATES,P.A.
`1619 NW 136th Avenue, Suite 2C
`Sunrise, Florida 33323
`Telephone (954) 744-8383
`Facsimile (954) 391-7805
`Email: efilings@pip-lawyers.com
`
`By:
`
` /s/Gregory E. Gudin
`GREGORYE. GUDIN,ESQ.
`Florida Bar # 14347
`
`[405-00106/32935064/1]
`
`

`

`
`Align Your Spine
`4800 W.
`illsboro Bivd A11
`Coconut Creek , FL 33073
`(954) 481-2828
`
`Name
`Stateme
`
`Date
`
`: 1/ 1/18 - 3/31/19
`
`> Zahava Merlis
`
`: Elaina Merlis
`
`Policy#: 981150147
`
`(D#: 2257
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`Carrier: Allstate - Florida PIP
`P.O. Box 660636
`Dallas TX 75266
`
`Date
`11/15/18
`
`11/15/18
`
`11/15/18
`
`11/18/18
`
`1115/18
`
`11/15/18
`
`11/18/18
`
`11/19/18 ; Zahava Merlis
`
`
`Charges
`Units
`Description
`Code
`$210.00
`1
`New Patient Exam
`$9204
`$0.00
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`iP
`11/18/18
`
`72052~=—Davis Series 1 $150.00
`
`IP
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`11/15/18
`
`72070+=X-Rays Th 1 $170.00
`
`IP
`Ins. Payment 2/11/2019 CHK# 684173930 Alistate- Floric!
`$0.00
`72100
`X-Rays L2
`$85.00
`(P
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Flore
`$0.00
`97010
`Heat/Cold Therapy
`1
`$39.00
`IP
`Ins. Payment 2/11/2019 CHK#684173930 Allstate - Flori!
`$0.00
`97012
`Mechanical Traction
`$30.00
`IP
`Ins. Payment 2/11/2019 CHK#684173930 Allstate-Per
`$0.00
`G0283
`Electrical Muscle Stimulation PIP
`$40.00
`IP
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Fiovie 4
`$0.00
`97535
`Activities of Daily Living
`1
`$52.00
`IP
`Ins. Payment 2/11/2019 CHK#684173930 Allstate - Floric '
`$0.00
`7035
`Ultrasound
`$48.00
`iP
`Ins. Payment 2/11/2019 CHK# 684173930 Alistate - Flori
`$0.00
`11/18/18
`
`ollar|Cervical Coller 1 $50.00
`
`P
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`9273
`Ice Pack Large
`2
`$60.00
`P
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`9270
` Biofreeze Roll-on
`1
`$14.00
`8941
`C/T Adjustments 3-4 Levels
`1
`$70.00
`Pp
`Ins. Payment 2/11/2019 CHK#684173930 Allstate - Flric®
`$0.00
`8943
`Extremitiy Adjustment
`$48.00
`P
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric ‘
`$0.00
`7010
`Heat/Cold Therapy
`1
`$39.00
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`Mechanical Traction
`1
`$30.00
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`Electrical Muscle Stimulation PIP
`1
`$40.00
`Ins, Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`Therapeutic Exercise
`1
`$59.00
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`$0.00
`
`WM/15/18
`
`11/15/18
`11/19/18
`
`11/19/18
`
`11/19/18
`
`11/19/18
`
`NHN9N8
`
`7012
`
`0283
`
`7110
`
`Wednesday, March 13, 2019
`
`
`
`

`

`
`
`Name
`Statement Date
`
`: Zahava Merlis
`21/1/18 - 3/31/19
`
`ID#: 2257
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`11/26/18
`
`N21N§
`
`T2118
`
`11/21/18
`
`11/21/18
`
`11/21/18
`
`W218
`
`N/21N8
`
`11/26/18
`
`11/26/18
`
`11/26/18
`
`11/26/18
`
`11/26/18
`
`11/26/18
`
`Ultrasound
`
`C/T Adjustments 3-4 Levels
`
`1
`Posture PNF Neuromuscular Re-Ed
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`Manual Therapy
`1
`Ins, Payment 2/11/2019 CHK# 684173930 Allstate - Flori *
`Ins. Payment 2/11/2019 CHK#684173930 Allstate-Fes
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Fiore 4
`Extremitiy Adjustment
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Fioric 1
`Heat/Cold Therapy
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Flori *
`ins. Payment 2/11/2019 CHK#684173930 Allstate - Fiore 1
`
`Mechanical Traction
`
`1
`Electrical Muscle Stimulation PIP
`ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`Ultrasound
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`Therapeutic Exercise
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Alistate - Floric 1
`Posture PNF Neuromuscular Re-Ed
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`Manual Therapy
`1
`Ins. Payment 2/11/2019 CHK# 684173930 Allstate - Floric 1
`C/T Adjustments 3-4 Levels
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Alistate - Floric 1
`Extremitiy Adjustment
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Heat/Cold Therapy
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Mechanical Traction
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Electrical Muscle Stimulation PIP
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Ultrasound
`1
`ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Therapeutic Exercise
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Posture PNF Neuromuscular Re-Ed
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Manual Therapy
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`C/T Adjustments 3-4 Levels
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Flori*
`Ins. Payment 2/11/2019 CHK#684173935 Allstate- Flori
`
`Extremitiy Adjustment
`
`1
`Heat/Cold Therapy
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Mechanical Traction
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Electrical Muscle Stimulation PIP
`4
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Ultrasound
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Therapeutic Exercise
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Alistate - Floric 1
`
`$58.00
`$0.00
`$54.00
`$0.00
`$48.00
`$0.00
`$70.00
`$0.00
`$48.00
`$0.00
`$39.00
`$0.00
`$30.00
`$0.00
`$40.00
`$0.00
`$48.00
`$0.00
`$59.00
`$0.00
`$58.00
`$0.00
`$54.00
`$0.00
`$70.00
`$0.00
`$48.00
`$0.00
`$39.00
`$0.00
`$30.00
`$0.00
`$40.00
`$0.00
`$48.00
`$0.00
`$59.00
`$0.00
`$58.00
`$0.00
`$54.00
`$0.00
`$70.00
`$0.00
`$48.00
`$0.00
`$39.00
`$0.00
`$30.00
`$0.00
`$40.00
`$0.00
`$48.00
`$0.00
`$59.00
`$0.00
`
`($24.82)
`$0.00
`($22.46)
`$0.00
`($47.20)
`
`($56.00)
`$0.00
`($25.60)
`$0.00
`($8.00)
`$0.00
`($24.00)
`$0.00
`($24.82)
`$0.00
`($22.46)
`$0.00
`($47.20)
`
`ednesday, March 13, 2019
`
`

`

`Name
`Statement Date
`
`: Zahava Merlis
`: 1/ 1/18 - 3/31/19
`
`ID#: 2257
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`11/2618
`
`11/26/18
`
`$0.00
`$58.00
`1
`Posture PNF Neuromuscular Re-Ed
`97112
`($46.40)
`$0.00
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`IP
`$0.00
`$54.00
`Manual Therapy
`1
`97140
`($43.20)
`$0.00
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`IP
`
`11/26/18 phyto4=Anti Inflammatory - Phyto 4 1 $45.00 $0.00
`
`
`
`11/27/18
`99214
`Established Patient Exam Level Four
`1
`$120.00
`$0.00
`
`11/27/18
`
`98941
`
`C/T Adjustments 3-4 Levels
`
`$70.00
`
`$0.00
`
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Flori!
`Ins. Payment 2/11/2019 CHK#684173935 Allstate-Fes
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Flotie 4
`
`$0.00
`$0.00
`$0.00
`
`($86.00)
`($56.00)
`($25.60)
`
`
`
`IP
`IP
`IP
`
`
`
`
`
`11/27/18 98943—Extremitiy Adjustment $48.00 $0.00
`
`11/27/18
`
`11/2718
`
`11/27/18
`
`11/27/18
`
`11/27/18
`
`11/27/18
`
`11/278
`
`11/29/18
`
`97010
`ip
`97012
`IP
`G0283
`
`1
`Heat/Cold Therapy
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Mechanical Traction
`1
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`Electrical Muscle Stimulation PIP
`1
`
`$39.00
`$0.00
`$30.00
`$0.00
`$40.00
`
`$0.00
`($8.00)
`$0.00
`($24.00)
`$0.00
`
`IP
`IP
`iP
`IP
`
`97035
`
`97110
`
`97112
`
`Ultrasound
`
`Therapeutic Exercise
`
`Ins. Payment 2/11/2019 CHK#684173935 Allstate - Flori?
`Ins. Payment 2/11/2019 CHK#684173935 Allstate- Fr
`Ins. Payment 2/11/2019 CHK#684173935 Allstate-Fes
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Flore 1
`
`Posture PNF Neuromuscular Re-Ed
`
`$48.00
`
`$0.00
`$0.00
`$0.00
`$0.00
`
`$59.00
`
`$58.00
`
`$0.00
`
`($24.82)
`($22.46)
`($47.20)
`($46.40)
`
`$0.00
`
`$0.00
`
`97140
`IP
`11/29/18 98941
`IP
`98943
`IP
`11/29/18] 97010
`IP
`IP
`
`11/29/18} 97012
`
`11/29/18) GO283
`IP
`11/29/18] 97035
`
`11/29/18] 97110
`
`iP
`IP
`
`4
`Manual Therapy
`Ins. Payment 2/11/2019 CHK# 684173935 Allstate - Floric 1
`C/T Adjustments 3-4 Levels
`1
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric 1
`Extremitiy Adjustment
`1
`ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric 1
`Heat/Cold Therapy
`1
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Flori?
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Flat
`
`Mechanical Traction
`
`1
`Electrical Muscle Stimulation PIP
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric 1
`Ultrasound
`1
`
`ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric *
`Ins. Payment 2/11/2019 CHK#684173934 Allstate - Flotie 4
`
`Therapeutic Exercise
`
`$54.00
`$0.00
`$70.00
`$0.00
`$48.00
`$0.00
`$39.00
`$0.00
`$0.00
`
`$30.00
`
`$40.00
`$0.00
`$48.00
`
`$59.00
`
`$0.00
`$0.00
`
`$0.00
`($43.20)
`$0.00
`($56.00)
`$0.00
`($25.60)
`$0.00
`($8.00)
`($24.00)
`
`$0.00
`
`$0.00
`($24.82)
`$0.00
`
`($22.46)
`($47.20)
`
`$0.00
`
`
`
`11/29/18! 97112|Posture PNF Neuromuscular Re-Ed i $58.00 $0.00
`
`IP
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric 1
`$0.00
`($46.40)
`11/29/18 97140
`Manual Therapy
`1
`$54.00
`$0.00
`IP
`Ins. Payment 2/11/2019 CHK# 684173934 Allstate - Floric 1
`$0.00
`($38.85)
`
`12/48|98941 C/T Adjustments 3-4 Levels 1 $70.00 $0.00
`
`
`
`
`12/4/18|98943 Extremitiy Adjustment 1 $48.00 $0.00
`
`
`
`
`12/4/18|97010 Heat/Cold Therapy 1 $39.00 $0.00
`
`
`
`
`12/48|97012 Mechanical Traction 1 $30.00 $0.00
`
`
`
`
`12/4/18|G0283 Electrical Muscle Stimulation PIP 1 $40.00 $0.00
`
`
`
`
`12/4/18|97035 Ultrasound 1 $48.00 $0.00
`
`
`
`
`12/418|97110 Therapeutic Exercise 1 $59.00 $0.00
`
`
`
`
`12/48|97112 Posture PNF Neuromuscular Re-Ed 1 $58.00 $0.00
`
`
`
`
`12/4/18|97140 Manual Therapy 1 $54.00 $0.00
`
`
`
`
`12/5/18|98941 C/T Adjustments 3-4 Levels 1 $70.00 $0.00
`
`
`
`
`12/5/18|97022 Whirlpool 1 $36.00 $0.00
`
`
`
`12/5/18|98943—Extremitiy Adjustment 1 $48.00 $0.00
`
`
`
`12/5/18|G0283 Electrical Muscle Stimulation PIP 1 $40.00 $0.00
`
`
`
`
`ednesday, March 13, 2019
`
`

`

`Name
`Statement Date
`
`: Zahava Merlis
`21/148 - 3/31/19
`
`ID#: 2257
`
`
`
`
`
`
`
`Ultrasound
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Ultrasound
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`C/T Adjustments 3-4 Levels
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`Established Patient Exam Level Four
`C/T Adjustments 3-4 Levels
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`C/T Adjustments 3-4 Levels
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Ultrasound
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`C/T Adjustments 3-4 Levels
`Whiripoo!
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Extremitiy Adjustment
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpoot
`C/T Adjustments 3-4 Levels
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`ManualTherapy
`Whirlpool
`C/T Adjustments 3-4 Levels
`
`ehekekekADdkedodtdokAQodwdodA)odododeeokwooraseosasaka)OSoeokOkokADotmeorerwettes
`
`$48.00
`$59.00
`$58.00
`$54.00
`$70.00
`$48.00
`$40.00
`$48.00
`$59.00
`$58.00
`$54.00
`$36.00
`$70.00
`$48.00
`$40.00
`$118.00
`$58.00
`$54.00
`$36.00
`$120.00
`$70.00
`$48.00
`$40.00
`$118.00
`$58.00
`$54.00
`$36.00
`$70.00
`$48.00
`$40.00
`$48.00
`$59.00
`$58.00
`$54.00
`$36.00
`$70.00
`$36.00
`$48.00
`$40.00
`$59.00
`$58.00
`$108.00
`$70.00
`$48.00
`$40.00
`$118.00
`$58.00
`$54.00
`$36.00
`$70.00
`$40.00
`$118.00
`$58.00
`$54.00
`$36.00
`$70.00
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
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`$0.00
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`$0.00
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`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`
`$0.00
`$0.00
`
`12/5/18
`12/5/18
`12/5/18
`12/5/18
`12/6/18
`12/618
`12/6/18
`12/6/18
`12/6/18
`12/6/18
`
`
`
`
`‘ednesday, March 13, 2019
`
`
`

`

`G0283
`97110
`97112
`97140
`97022
`97110
`97112
`97140
`E0855
`98941
`99214
`98941
`97022
`G0283
`97110
`97112
`
`
`
`
`
`1/16/19
`16/19
`169
`TA7N9
`W179
`W179
`1N7N9
`1A7AN9
`WM17/19
`1/21/19
`1/21/19
`1/21/19
`1/21/19
`W21119
`1/2119
`1/22/19
`1/22/19
`1/22/19
`1/22/19
`1/22/19
`1/22/19
`1/24/19
`1/24/19
`1/24/19
`1/24/19
`1/24/19
`1/2419
`1/28/19
`1/28/19
`1/28/19
`1/28/19
`1/28/19
`1/28/19
`1/30/19
`1/30/19
`1/30/19
`
`: Zahava Merlis
`2 1/1/18 - 3/31/19
`
`ID#: 2257
`
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpoo!
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Cervical Traction Collar
`C/T Adjustments 3-4 Levels
`Established Patient Exam Level Four
`C/T Adjustments 3-4 Levels
`Whirlpos!
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`ManualTherapy
`Posture PNF Neuromuscular Re-Ed
`Therapeutic Exercise
`Electrical Muscle Stimulation PIP
`Whirlpool
`C/T Adjustments 3-4 Levels
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual! Therapy
`Established Patient Exam Level Four
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`C/T Adjustments 3-4 Levels
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`
`SAAAAAAAAAAARNONO
`
`$40.00
`$59.00
`$58.00
`$54.00
`$36.00
`$59.00
`$58.00
`$54.00
`$97.99
`$70.00
`$120.00
`$70.00
`$36.00
`$40.00
`$118.00
`$58.00
`$54.00
`$70.00
`$36.00
`
`$118.00
`$58.00
`$54.00
`$70.00
`$36.00
`$40.00
`$118.00
`$58.00
`$54.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$54.00
`$58.00
`$118.00
`$40.00
`$36.00
`$70.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$120.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$70.00
`$59.00
`$58.00
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
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`$0.00
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`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`
`Wednesday, March 13, 2019
`
`
`
`

`

`Name
`Statement Date
`
`: Zahava Merlis
`: 1/1/18 - 3/31/19
`
`ID#: 2257
`
`1/30/19
`1/30/19
`1/30/19
`1/31/19
`1/31/19
`1/31/19
`1831/19
`1/31/19
`131/19
`2/4119
`2/419
`2/49
`2/4/19
`2/4119
`2/4/19
`2/6/19
`2/6/19
`2/6/19
`2/6/19
`2/6/19
`2/6/19
`2/11/19
`2/11/19
`2/11/19
`2/11/19
`2/11/19
`2/11/19
`2/13/19
`2/13/19
`2/13/19
`2/13/19
`2/13/19
`2/13/19
`2/20/19
`2/20/19
`2/20/19
`2/20/19
`2/20/18
`2/20/19
`2/21/19
`2/21/19
`2/21/19
`2/21/19
`2/21/19
`2/21/19
`2/25/19
`2/25/19
`2/2519
`2/25/19
`2/25/19
`2/25/19
`2/27/19
`2/27/19
`2/27/19
`2/27/19
`2/27/19
`
`97140
`97022
`G0283
`98941
`97110
`97112
`97140
`97022
`G0283
`98944
`97022
`G0283
`97110
`97112
`97140
`98941
`97022
`G0283
`97110
`97112
`97140
`98941
`97022
`G0283
`97110
`97112
`97140
`98941
`97022
`G0283
`97710
`97112
`97140
`98941
`G0283
`97110
`97112
`97140
`97022
`98941
`G0283
`97110
`97112
`97140
`97022
`98941
`G0283
`97110
`97112
`97140
`97022
`98941
`G0283
`97110
`97112
`97140
`
`Manual Therapy
`Whirlpool
`Electrical Muscle Stimulation PIP
`C/T Adjustments 3-4 Levels
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`Electrical Muscle Stimulation PiP
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirfpoo!
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Whirlpool
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`C/T Adjustments 3-4 Levels
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whiripcol
`C/T Adjustments 3-4 Levels
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool
`C/T Adjustments 3-4 Levels
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`Whirlpool!
`C/T Adjustments 3-4 Levels
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`
`ednesday, March 13, 2019
`
`
`
`
`
`aABPBradtBeanssnAarewrtantanennmenesnnnnmonnnnnnnnnnnnnanaas
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`$54.00
`$36.00
`$40.00
`$70.00
`$59.00
`$58.00
`$54.00
`$36.00
`$40.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$70.00
`$36.00
`$40.00
`$59.00
`$58.00
`$54.00
`$70.00
`
`$59.00
`$58.00
`$54.00
`$36.00
`$70.00
`
`$59.00
`$58.00
`$54.00
`$36.00
`$70.00
`$40.00
`$59.00
`$58.00
`$54.00
`$36.00
`$70.00
`$40.00
`$59.00
`$58.00
`$54.00
`
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
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`$0.00
`$0.00
`$0.00
`$0.00
`
`

`

`Name
`Statement Date
`
`: Zahava Merlis
`2 1/1/18 - 3/31/19
`
`ID#: 2257
`
`Dr.Jordan Mastronardi D.C.
`TAX ID: 20-4897724
`
`2/2719
`3/4/19
`3/4/19
`3/4/19
`3/4/19
`3/4/19
`3/4/19 ©
`3/4N9
`
`97022
`99455
`98941
`97022
`G0283
`97110
`97112
`97140
`
`Whiripool
`Final Exam
`C/T Adjustments 3-4 Levels
`Whirlpool!
`Electrical Muscle Stimulation PIP
`Therapeutic Exercise
`Posture PNF Neuromuscular Re-Ed
`Manual Therapy
`
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`$0.00
`
`$14,744.99
`
`($2,500.00)
`
`ednesday, March 13, 2019
`
`

`

`aAnmouzations &
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`R
`
`
`
`
`“4
`& Releases
`8
`Ant
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`‘4800W.HillsboroBivdSuiteAll, CoconutCreek. 5073 Ph.954,481.2978 Bx.954.481.2830
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