Exhibit 10.10

AMENDMENT NO. 2 TO CREDIT AGREEMENT

     This Amendment No. 2 to Credit Agreement (this “Agreement”) dated as of
March 10, 2005 is made by and among PEDIATRIX MEDICAL GROUP, INC., a Florida
corporation, and certain of its subsidiaries and affiliates (collectively, the
“Borrowers”), BANK OF AMERICA, N.A., a national banking association organized
and existing under the laws of the United States (“Bank of America”), in its
capacity as administrative agent for the Lenders (as defined in the Credit
Agreement (as defined below)) (in such capacity, the “Administrative Agent”),
and each of the Lenders signatory hereto.

W I T N E S S E T H:

     WHEREAS, the Borrowers, the Administrative Agent and the Lenders have
entered into that certain Credit Agreement dated as of July 30, 2004 (as
previously amended and as hereby amended and as from time to time hereafter
further amended, modified, supplemented, restated, or amended and restated, the
“Credit Agreement”; capitalized terms used in this Agreement not otherwise
defined herein shall have the respective meanings given thereto in the Credit
Agreement), pursuant to which the Lenders have made available to the Borrower a
revolving credit facility, including a letter of credit facility and a swing
line facility; and

     WHEREAS, the Borrower has advised the Administrative Agent and the Lenders
that it desires to amend certain provisions of the Credit Agreement as set forth
below and the Administrative Agent and the Lenders signatory hereto are willing
to effect such amendment on the terms and conditions contained in this
Agreement;

     NOW, THEREFORE, in consideration of the premises and further valuable
consideration, the receipt and sufficiency of which is hereby acknowledged, the
parties hereto agree as follows:

     1. Amendments to Credit Agreement. Subject to the terms and conditions set
forth herein, the Credit Agreement is hereby amended as follows:

     (a) Section 2.14(a) of the Credit Agreement is hereby amended by deleting
the reference to “$50,000,000” in such section and replacing it with
“$80,000,000” in lieu thereof.

     (b) Section 6.11 of the Credit Agreement is hereby amended by deleting such
section in its entirety and replacing it with the following:

     6.11 Use of Proceeds. Use the proceeds of the Credit Extensions for general
corporate purposes not in contravention of any Law or of any Loan Document;
provided, however, that neither the Company nor any other Borrower may use the
proceeds of Credit Extensions to purchase or otherwise acquire any shares of
capital stock of the Company unless (i) such purchase or acquisition is
permitted by Section 7.07(c), (d) or (f) and (ii) any shares of such capital
stock of the Company so acquired are retired or otherwise relegated to
“unissued” status immediately following the purchase or other acquisition
thereof.

 

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     (c) Section 6.02(b) of the Credit Agreement is hereby amended by deleting
such section in its entirety and replacing it with the following:

     (b) concurrently with the delivery of the financial statements referred to
in Sections 6.01(a) and (b), (i) a duly completed Compliance Certificate signed
by a Responsible Officer of the Company, (ii) an updated Schedule 5.05 and an
updated part (a) of Schedule 5.13, showing all information required to be set
forth in each such Schedule, updated since the last delivery thereof, and
(iii) in the event that any one or more programs for the purchase or other
acquisition of Equity Interests issued by the Company was in effect as of the
date of such financial statements but had not at such time been fully
implemented, a certificate demonstrating Consolidated Net Worth as of the date
of such financial statements giving pro forma effect to the full implementation
of each such program then in effect (which may be included as part of the
Compliance Certificate required by part (i) of this Section 6.02(b) above).

     (d) Section 7.07 of the Credit Agreement is hereby amended by (i) deleting
the word “and” at the end of subsection (d) thereof, (ii) deleting the period at
the end of subsection (e) thereof and replacing it with “; and”, and
(iii) adding the following new subsection (f) to Section 7.07:

     (f) the Company may make open market purchases or other acquisitions of
Equity Interests issued by it so long as (i) immediately after giving effect to
any such purchase or other acquisition, the Borrowers are in pro forma
compliance with each of the financial covenants set forth in Section 7.12, and
(ii) promptly following the adoption by the Board of Directors (or other
appropriate governing body) of the Company of any program for such purchases or
other acquisitions (and prior to making any purchase or other acquisition
pursuant to such a program), the Company delivers to the Administrative Agent a
certificate demonstrating pro forma compliance with the Consolidated Net Worth
covenant set forth in Section 7.12(a) as of the date thereof and giving effect
to all repurchases or other acquisitions permitted under such program and any
other program then in effect.

     2. Effectiveness; Conditions Precedent. The effectiveness of this Agreement
and the amendments to the Credit Agreement herein provided are subject to the
satisfaction of the following conditions precedent, after which such
satisfaction the amendments to the Credit Agreement herein provided shall be
deemed to be effective as of the Closing Date of the Credit Agreement:

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     (a) the Administrative Agent shall have received each of the following
documents or instruments in form and substance reasonably acceptable to the
Administrative Agent:

     (i) an original or facsimile (promptly followed by originals) executed
counterpart of this Agreement, duly executed by each Borrower, the
Administrative Agent and the Required Lenders;

     (ii) such other documents, instruments, certifications, undertakings,
further assurances and other matters as the Administrative Agent shall
reasonably request; and

     (iii) a certificate from a Responsible Officer of the Company demonstrating
pro forma compliance with the Consolidated Net Worth covenant set forth in
Section 7.12(a) after giving effect to all purchases or other acquisitions of
Equity Interests of the Company authorized to be made pursuant to an approved
program, whether or not actually made, on or at any time after the Closing Date
and through the date of this Agreement; and

     (b) all fees and expenses payable to the Administrative Agent and the
Lenders (including the fees and expenses of counsel to the Administrative Agent)
invoiced to date shall have been paid in full.

     3. Consent and Continued Enforceability. Each Borrower hereby consents,
acknowledges and agrees to the amendments set forth herein and hereby confirms
and ratifies in all respects its obligations under the Credit Agreement and each
other Loan Document (including without limitation the continuation of such
Borrower’s payment and performance obligations thereunder upon and after the
effectiveness of this Agreement and the amendments contemplated hereby) and the
enforceability of each such Loan Document against such Borrower in accordance
with its terms.

     4. Representations and Warranties. In order to induce the Administrative
Agent and the Lenders to enter into this Agreement, each Borrower represents and
warrants to the Administrative Agent and the Lenders as follows:

     (a) The representations and warranties made by each Borrower in Article V
of the Credit Agreement and in each of the other Loan Documents to which such
Borrower is a party are true and correct on and as of the date hereof, except to
the extent that such representations and warranties expressly relate to an
earlier date, and except that for purposes of this Section 4, the
representations and warranties contained in subsections (a) and (b) of
Section 5.05 of the Credit Agreement shall be deemed to refer to the most recent
statements furnished pursuant to clauses (a) and (b), respectively, of
Section 6.01 of the Credit Agreement;

     (b) Other than the matters set forth on Schedule 5.06 of the Credit
Agreement, since the date of the Audited Financial Statements, there has been no
event or circumstance, either individually or in the aggregate, that has had or
could reasonably be expected to have a Material Adverse Effect;

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     (c) The Persons appearing as Borrowers on the signature pages to this
Agreement constitute all Persons who are required to be Borrowers pursuant to
the terms of the Credit Agreement and the other Loan Documents, including
without limitation all Persons who became Material Subsidiaries or were
otherwise required to become Borrowers after the Closing Date, and each of such
Persons has become and remains a party to the Credit Agreement as a Borrower;

     (d) This Agreement has been duly authorized, executed and delivered by the
Borrowers party hereto and constitutes a legal, valid and binding obligation of
such parties, except as may be limited by general principles of equity or by the
effect of any applicable bankruptcy, insolvency, reorganization, moratorium or
similar law affecting creditors’ rights generally; and

     (e) No Default or Event of Default has occurred and is continuing.

     5. Entire Agreement. This Agreement, together with all the Loan Documents
(collectively, the “Relevant Documents”), sets forth the entire understanding
and agreement of the parties hereto in relation to the subject matter hereof and
supersedes any prior negotiations and agreements among the parties relating to
such subject matter. No promise, condition, representation or warranty, express
or implied, not set forth in the Relevant Documents shall bind any party hereto,
and no such party has relied on any such promise, condition, representation or
warranty. Each of the parties hereto acknowledges that, except as otherwise
expressly stated in the Relevant Documents, no representations, warranties or
commitments, express or implied, have been made by any party to the other. None
of the terms or conditions of this Agreement may be changed, modified, waived or
canceled orally or otherwise, except in writing and in accordance with
Section 10.01 of the Credit Agreement.

     6. Full Force and Effect of Agreement. Except as hereby specifically
amended, modified or supplemented, the Credit Agreement and all other Loan
Documents are hereby confirmed and ratified in all respects and shall be and
remain in full force and effect according to their respective terms, with the
amendments provided herein deemed to have been effective as of the Closing Date
of the Credit Agreement.

     7. Counterparts. This Agreement may be executed in any number of
counterparts, each of which shall be deemed an original as against any party
whose signature appears thereon, and all of which shall together constitute one
and the same instrument. Delivery of an executed counterpart of a signature page
of this Agreement by telecopy shall be effective as delivery of a manually
executed counterpart of this Agreement.

     8. Governing Law. This Agreement shall in all respects be governed by, and
construed in accordance with, the laws of the State of New York applicable to
contracts executed and to be performed entirely within such State, and shall be
further subject to the provisions of Sections 10.14 and 10.15 of the Credit
Agreement.

     9. Enforceability. Should any one or more of the provisions of this
Agreement be determined to be illegal or unenforceable as to one or more of the
parties hereto, all other provisions nevertheless shall remain effective and
binding on the parties hereto.

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     10. References. All references in any of the Loan Documents to the “Credit
Agreement” shall mean the Credit Agreement, as amended hereby.

     11. Successors and Assigns. This Agreement shall be binding upon and inure
to the benefit of the Borrower, the Administrative Agent and each of the
Guarantors and Lenders, and their respective successors, legal representatives,
and assignees to the extent such assignees are permitted assignees as provided
in Section 10.04 of the Credit Agreement.

[Signature pages follow.]

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     IN WITNESS WHEREOF, the parties hereto have caused this instrument to be
made, executed and delivered by their duly authorized officers as of the day and
year first above written.

            BORROWERS:

PEDIATRIX MEDICAL GROUP, INC., a
Florida corporation
      By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner        Title:  
Chief Financial Officer     

            ALASKA NEONATOLOGY ASSOCIATES, INC.
ASSOCIATES IN NEONATOLOGY, INC.
AUGUSTA NEONATOLOGY ASSOCIATES, P.C.
BNA ACQUISITION COMPANY, INC.
CENTRAL OKLAHOMA NEONATOLOGY ASSOCIATES, INC.
CNA ACQUISITION CORP.
FLORIDA REGIONAL NEONATAL ASSOCIATES, INC.
FOOTHILL MEDICAL GROUP, INC.
FORT WORTH NEONATAL ASSOCIATES BILLING, INC.
GNPA ACQUISITION COMPANY, INC.
MAGELLA HEALTHCARE CORPORATION
MAGELLA HEALTHCARE GROUP, L.P.
MAGELLA MEDICAL ASSOCIATES BILLING, INC.
MAGELLA MEDICAL ASSOCIATES MIDWEST, P.C.
MAGELLA MEDICAL ASSOCIATES OF GEORGIA, P.C.
MAGELLA MEDICAL GROUP, INC.
MAGELLA NEVADA, LLC
MAGELLA TEXAS, LLC
                       

                  By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner       
Title:   Attorney-in-Fact     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            MNPC ACQUISITION COMPANY, INC.
MOUNTAIN STATES NEONATOLOGY, INC.
NACF ACQUISITION COMPANY, INC.
NEONATAL AND PEDIATRIC INTENSIVE CARE MEDICAL GROUP, INC.
NEONATOLOGY ASSOCIATES BILLING, INC.
NEONATAL SPECIALISTS, LTD.
NSPA ACQUISITION COMPANY, INC.
OBSTETRIX ACQUISITION COMPANY OF ARIZONA, INC.
OBSTETRIX ACQUISITION COMPANY OF COLORADO, INC.
OBSTETRIX MEDICAL GROUP OF ARIZONA, P.C.
OBSTETRIX MEDICAL GROUP OF CALIFORNIA, A PROFESSIONAL CORPORATION
OBSTETRIX MEDICAL GROUP OF COLORADO, P.C.
OBSTETRIX MEDICAL GROUP OF KANSAS AND MISSOURI, P.A.
OBSTETRIX MEDICAL GROUP OF PHOENIX, P.C.
OBSTETRIX MEDICAL GROUP OF TEXAS BILLING, INC.
OBSTETRIX MEDICAL GROUP OF WASHINGTON, INC., P.S.
OBSTETRIX MEDICAL GROUP, INC.
OZARK NEONATAL ASSOCIATES, INC.
PALM BEACH NEO ACQUISITIONS, INC.
PASCV ACQUISITION COMPANY, INC.
PEDIATRIX ACQUISITION COMPANY OF OHIO, INC.
PEDIATRIX ACQUISITION COMPANY OF WASHINGTON, INC.
PEDIATRIX FLORIDA LLC
                       

                  By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner       
Title:   Attorney-in-Fact     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            PEDIATRIX MEDICAL GROUP NEONATOLOGY AND PEDIATRIC INTENSIVE CARE
SPECIALISTS OF
NEW YORK, P.C.
PEDIATRIX MEDICAL GROUP OF ARKANSAS, P.A.
PEDIATRIX MEDICAL GROUP OF CALIFORNIA, A PROFESSIONAL CORPORATION
PEDIATRIX MEDICAL GROUP OF COLORADO, P.C.
PEDIATRIX MEDICAL GROUP OF DELAWARE, INC.
PEDIATRIX MEDICAL GROUP OF FLORIDA, INC.
PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C.
PEDIATRIX MEDICAL GROUP OF ILLINOIS, P.C.
PEDIATRIX MEDICAL GROUP OF INDIANA, P.C.
PEDIATRIX MEDICAL GROUP OF KANSAS, P.A.
PEDIATRIX MEDICAL GROUP OF KENTUCKY, P.S.C.
PEDIATRIX MEDICAL GROUP OF LOUISIANA, L.L.C.
PEDIATRIX MEDICAL GROUP OF MICHIGAN, P.C.
PEDIATRIX MEDICAL GROUP OF MISSOURI, P.C.
PEDIATRIX MEDICAL GROUP OF NEW MEXICO, P.C.
PEDIATRIX MEDICAL GROUP OF NORTH CAROLINA, P.C.
PEDIATRIX MEDICAL GROUP OF OHIO CORP.
PEDIATRIX MEDICAL GROUP OF OKLAHOMA, P.C.
                       

                  By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner       
Title:   Attorney-in-Fact     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            PEDIATRIX MEDICAL GROUP OF PENNSYLVANIA, P.C.
PEDIATRIX MEDICAL GROUP OF PUERTO RICO, P.S.C.
PEDIATRIX MEDICAL GROUP OF SOUTH CAROLINA, P.A.
PEDIATRIX MEDICAL GROUP OF TENNESSEE, P.C.
PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC
PEDIATRIX MEDICAL GROUP OF WASHINGTON, INC., P.S.
PEDIATRIX MEDICAL GROUP, INC., a Utah corporation
PEDIATRIX MEDICAL GROUP, P.A.
PEDIATRIX MEDICAL GROUP, P.C., a Virginia corporation
PEDIATRIX MEDICAL GROUP, P.C., a West Virginia corporation
PEDIATRIX MEDICAL MANAGEMENT, L.P.
PEDIATRIX MEDICAL SERVICES, INC.
PEDIATRIX OF MARYLAND, P.A.
PEDIATRIX SCREENING, INC.
PEDIATRIX TEXAS I LLC
PEDIATRIX VIRGINIA ACQUISITION COMPANY, INC.
PERINATAL PEDIATRICS, P.A.
PMG ACQUISITION CORP.
PMGSC, P.A.
PNA ACQUISITION CO., INC.
POKROY MEDICAL GROUP OF NEVADA, LTD.
RPNA ACQUISITION COMPANY, INC.
SCPMC ACQUISITION CO.
SNCA ACQUISITION COMPANY, INC.
ST. JOSEPH NEONATOLOGY CONSULTANTS, INC.
                       

                  By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner       
Title:   Attorney-in-Fact     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            TEXAS MATERNAL FETAL MEDICINE BILLING, INC.
TEXAS NEWBORN SERVICES, INC.
TUCSON PERINATAL SERVICES, P.C.
                       

                  By:   /s/ Karl B. Wagner         Name:   Karl B. Wagner       
Title:   Attorney-in-Fact     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            ADMINISTRATIVE AGENT:

BANK OF AMERICA, N.A.,
as Administrative Agent
      By:   /s/ Kevin L. Ahart         Name:   Kevin L. Ahart        Title:  
Assistant Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            LENDERS:

BANK OF AMERICA, N.A. as a Lender, L/C Issuer and
Swing Line Lender
      By:   /s/ Richard C. Hardison         Name:   Richard D. Hardison       
Title:   Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            HSBC BANK USA, NATIONAL ASSOCIATION
        By:   /s/ Steven C. Mayer         Name:   Steven C. Mayer       
Title:   Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            SUNTRUST BANK
      By:   /s/ David P. Singleton         Name:   David P. Singleton       
Title:   Managing Director     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            U.S. BANK NATIONAL ASSOCIATION
      By:   /s/ S. Walker Choppin         Name:   S. Walker Choppin       
Title:   Senior Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            WACHOVIA BANK, N.A.
      By:   /s/ Juan C. Castro         Name:   Juan C. Castro        Title:  
Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            KEYBANK NATIONAL ASSOCIATION
      By:   /s/ J.T. Taylor         Name:  J.T. Taylor       Title:   Senior
Vice President     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            UBS LOAN FINANCE LLC
      By:   /s/ Edward Cripps         Name:   Edward Cripps        Title:  
Director     

                  By:   /s/ Joselin Fernandes         Name:   Joselin Fernandes 
      Title:   Associate Director     

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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            THE INTERNATIONAL BANK OF MIAMI, N.A.
      By:   /s/         Name:           Title:        

Pediatrix Medical Group, Inc.
Amendment No. 2 to Credit Agreement
Signature Pages

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