STATE OF FLORIDA DEPARTMENT OF HEALTH

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1 DEPARTMENT OF HEALTH, Petitioner, STATE OF FLORIDA DEPARTMENT OF HEALTH v. CASE NUMBER BALAMURALI K. AMBATI, M.D., Respondent. ADMINISTRATIVE COMPLAINT Petitioner Department of Health files this Administrative Complaint before the Board of Medicine against Respondent Balamurali K. Ambati, M.D., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed medical doctor within the state of Florida, having been issued license number ME Respondent's address of record is 2050 Goodpasture Loop, Unit 95, Eugene, OR

2 4. Respondent is also licensed to practice medicine in the state of Idaho by the Idaho Medical Board (Idaho Board), the licensing authority regulating the practice of medicine in Idaho. 5. On or about January 8, 2018, the Idaho Board took action against Respondent's license in case number via a Stipulation of Licensure and Order (Stipulation) for Respondent's failure to correctly answer three questions correctly on his application for license renewal. 6. The Stipulation required Respondent to pay a $1,500 fine ($500 for each false statement on his license application, required Respondent to pay investigative costs and attorney fees, and required Respondent to complete an ethics course. 7. The January 8, 2018, Stipulation of the Idaho Board constitutes action against Respondent's medical license. 8. Petitioner re-alleges and incorporates by reference paragraphs one (1) through seven (7), as if fully set forth herein. 9. Section (1)(b), Florida Statutes (2018), provides that having a license or the authority to practice medicine revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of any jurisdiction constitutes grounds for disciplinary action by the Board of Medicine. DOH v. Balamurali K. Ambati, M.D.; Case Number

3 10. The Idaho Board acted against Respondent's Idaho medical license by entering the above referenced Stipulation on or about January 8, Based on the foregoing, Respondent violated Section (1)(b), Florida Statutes (2018), by having his medical license acted against by the medical licensing authority of another jurisdiction. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. [Signature appears on the following page.] DOH v. Balamurali K. Ambati, M.D.; Case Number

4 SIGNED this 17th day of September Celeste Philip, MD, MPH Surgeon General and Secretary CLERK: DATE: FILED DEPARTMENT OF HEALTH DEPUTY CLERK Angel S9DdEiTS SEP Cy nthi,a/ N co4v-eaely Cynthia Nash-Early Assistant General Counsel Florida Bar Number DOH-Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida (850) (850) fax Cynthia.NashEarly@flhealth.gov CNE/tgc PCP Date: September 14, 2018 PCP Members: Mark Avila, M.D., M.D. and Steven Rosenberg, M.D. DOH v. Balamurali K. Ambati, M.D.; Case Number

5 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section and , Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule (2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule (4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule (5), Florida Administrative Code. Mediation under Section , Florida Statutes, is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section (4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. DOH v. Balamurali K. Ambati, M.D.; Case Number

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