Destination:
Cartagena Colombia
(This is Dr.
Gilman's 10th year
in Cartagena)
Home :
DOWNLOAD
MEMBERSHIP FORMS
HERE
This is to be
completed and faxed to the
HTCNE office
Immediately
(860) 350 6634 - fax
Next:
Click
Here for Online Registration
IF the chart below shows
that a
CV, Medical
License, Med. School
Diploma, or
Delineation of
Privileges is needed,
please fax or email
them to the office right
away. We need
these to secure your
working permits in
country.
(860) 350 6634 - fax
Destination:
Cartagena
Colombia
Specialty:
Plastic Surgery,
Cleft Lip
and Palate,
Hand and
General
Reconstructive
Surgery
Team Leader:
Dr. Robert
Gilman |
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Dates:
3/5/08 to
3/14/08 |
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Sponsor:
Rotary
Club of
Cartagena
Hospital:
Napoleon
Franco in
Cartagena
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Updates: |
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Site Contact
Info.:
Contact:
Pedro
Camacho
Hotel Info:
Hotel
Caribe
Phone 57 5
665 0155
Supplies/
shipping
contact:
Mr.
Juan
Salvat
Tel: (1)
305
5913732
/ 305-
2976146
6952 NW
51
Street,
Miami,
Florida
33166
See below
for flight
information
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Click on any
Team member
name in blue
to send an
e-mail |
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Administrative
Contact:
Lisa Magyar
lisa.magyar@sap.com |
mail entire
team |
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Participants: |
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SURGEONS: |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2006 Dues |
Air
Fare |
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Robert
Gilman,MD
Team Leader |
in |
cc |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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Richard
Ehrlichman,
MD
Plastic
Surg. |
in |
in |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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Jafar Hasan |
in |
in |
in |
NA |
in |
in |
in |
in |
in |
cc |
cc |
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Jerry Sepic |
in |
in |
in |
NA |
in |
in |
in |
in |
in |
pd |
pd |
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William Hyland |
in |
need |
in |
NA |
NA |
in |
in |
in |
in |
cc |
cc |
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ANESTHESIOLOGY: |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2006 Dues |
Air
Fare |
|
David
Napoli,
MD |
in |
in |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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JP Grimaldos, MD |
in |
in |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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Jeffrey Jankun, MD |
in |
in |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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PEDIATRICS:
PACU |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2005 Dues |
Air
Fare |
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Simi
Khangura,
MD |
in |
in |
in |
in |
in |
in |
in |
in |
in |
cc |
cc |
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NURSING:
OR |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2006 Dues |
Air
Fare |
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Kathleen
Pavesi,
RN
Head
OR |
in |
in |
in |
NA |
in |
in |
in |
in |
NA |
pd |
pd |
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Anne
Marie
Austin,
RN/OR |
in |
in |
in |
NA |
in |
in |
in |
in |
in |
pd |
pd |
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NURSING
/
PACU |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2006 Dues |
Air
Fare |
|
Margaret
DiStassio,
RN,RR |
in |
in |
in |
NA |
in |
in |
in |
in |
NA |
pd |
pd |
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Meredith Jones, RN |
in |
in |
in |
NA |
in |
in |
in |
in |
in |
pd |
pd |
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Administration |
CV |
Lic |
Diploma |
Del. of Privleg. |
Clinical
Specialty
Form
|
Health/
Med
Hist |
Signed
Release
|
Passport
Info |
Credit
Card
Auth |
2006 Dues |
Air
Fare |
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Lisa
Magyar |
NA |
NA |
NA |
NA |
NA |
in |
in |
in |
in |
cc |
pd * |
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Patrick Bullot |
NA |
NA |
NA |
NA |
NA |
need |
need |
in |
NA |
fund |
fund |
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Flights:
15 Members
7
passengers from
Boston
:
R.
Gilman, A. Austin,
J. Jankun, M. Jones,
D.
Napoli
, K. Pavesi, J.
Sepic
Airfare - $1044.67
AA
2189 05MAR BOSMIA
HK7 645A
1010A
AV 35
05MAR MIACTG
YK7 110P
346P
AV 34
14MAR CTGMIA
YK7 912A
1255P
AA1930 14MAR
MIABOS HK7
335P 650P
1
passenger from
Boston
:
R. Ehrlichman
Airfare: $997.19
AA
2189 05MAR BOSMIA
HK1 645A
1010A
AV 35
05MAR MIACTG
YK1 110P
346P
AV 34
12MAR CTGMIA
YK1 912A
1255P
AA1930 12MAR
MIABOS HK1
335P 650P
1
passenger from La
Guardia:
M.
Distassio
Airfare: $864.18
AA2103
05MAR LGAMIA
HK1 610A
910A
AV 35
05MAR MIACTG
YK1 110P
346P
AV 34 14MAR
CTGMIA YK1
912A 1255P
AA 592 14MAR
MIALGA
HK1 500P
805P
1 passenger from
Paris
:
Patrick Bullot
***Will
need to overnight in
Miami on way to
Cartagena
Airfare: $1389.48
AA
63 04MAR
CDGMIA HK1
1105A 320P
AV 35 05MAR
MIACTG YK1
110P 346P
AV 34 14MAR
CTGMIA YK1
912A 1255P
AA 62 14MAR
MIACDG HK1
610P 800A
1
passenger from
Tampa
:
JP.
Grimaldos
Airfare:
$843.27
AA1927
05MAR TPAMIA
950A
1050A
AV 35
05MAR MIACTG
110P
346P
AV 34
14MAR CTGMIA
912A
1255P
AA1960 14MAR MIATPA
305P
405P
1
passenger from
Myrtle Beach
:
W.
Hyland
Airfare: $1167.58
DL4175
05MAR MYRATL
615A
752A
DL1523 05MAR
ATLMIA
829A 1017A
AV 35 05MAR
MIACTG
110P
346P
AV 34 14MAR
CTGMIA
912A
1255P
DL1142 14MAR
MIAATL
550P
750P
DL4305 14MAR
ATLMYR
826P 1002P
1
passenger from
Dulles (return to
DCA)
L.
Magyar
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