In November 2014 the Florida Department of Health (FDOH) in Orange County received a report from FDOH online foodborne illness complaint system of a person diagnosed with Ciguatera Fish Poisoning. Multiple data sources were used to detect 5 additional cases. Local, state and federal agencies collaborated to conduct investigations at two restaurants, one grocery store, two fish distributors and one fish supplier to identify the outbreak food source. The six persons with Ciguatera Fish Poisoning had eaten black grouper either at a local restaurant or purchased from a grocery store. The fish was traced back to a common international distributor. All six persons experienced paradoxical temperature perception, nausea, paresthesias, numbness, abdominal pain, diarrhea arthralgias and myalgias. Medical care was sought, and supportive care was provided to 5 patients.