How to Start a Medical Practice in Florida: The Order of Operations

Updated 2026-10-23. Reviewed by Jacob Greenberg, ClaimCarePro. Every fee and timeline links to the agency, statute or regulation it comes from.

To start a medical practice in Florida, work in this order: form the entity on Sunbiz and get an EIN, get Type 1 and Type 2 NPIs, confirm Florida licensure and whether the practice needs an AHCA Health Care Clinic license or is exempt, register with the DEA if you will prescribe controlled substances, then complete CAQH and file Medicare, Florida Medicaid and commercial payer applications in parallel while you set up malpractice coverage, banking, the EHR, the clearinghouse and billing.

The order matters because each step feeds the next one's application. The payers ask for the NPI, the NPI asks for the legal name and address, and the legal name comes from Sunbiz. Get one record wrong early and every later application inherits the error. Our founders ran two medical practices, trained one practice's staff on its EHR and installed EHRs in two more, so this guide is written from the inside of the opening, not from a template.

Opening a PIP or auto-injury practice? The clinic-license test, EMC rules and 627.736 billing clocks are different; read how to start a PIP practice in Florida alongside this page. This guide covers administrative workflow, not legal or tax advice; a Florida health care attorney and a CPA should review your structure.

Want the payer side handled while you build the rest? Start credentialing now and you get a secure start link within one business hour.

What is the order of operations for opening a medical practice?

Identity first (entity, EIN, NPIs, license), then permission to operate (clinic license or exemption, DEA), then permission to be paid (CAQH, Medicare, Medicaid, commercial plans), then the machinery that collects (bank, EHR, clearinghouse, billing). The checklist below is the order we file in. The last column is what lets you save months.

How do you open a medical practice in Florida, step by step?

1. Form the entity on Sunbiz: PA, PLLC or LLC

A Florida medical practice is formed by filing articles with the Florida Division of Corporations on Sunbiz: profit corporation articles cost $70 and LLC articles cost $125, each including the registered agent designation. Those are the Division of Corporations' published fees (corporation: $35 filing plus $35 registered agent; LLC: $100 filing plus $25 registered agent). Certified copies and certificates of status are optional extras. Annual reports are due every year: $150 for a profit corporation and $138.75 for an LLC, rising to $550 and $538.75 if received after May 1.

Sunbiz lists no separate form for professional entities; the corporation and LLC articles are what it offers. The professional label lives in the name, under Fla. Stat. 621.12: a professional corporation uses "chartered," "professional association," "P.A." or "PA," and a professional LLC formed on or after January 1, 2014 uses "professional limited liability company," "P.L.L.C." or "PLLC." Choosing between them is a tax and liability decision, so make it with your CPA and attorney before you file, because the legal name you file becomes the name on every NPI, payer contract and bank account that follows.

One ownership decision belongs here too: who owns the entity decides whether you need an AHCA clinic license in step 5. Settle the owners before the articles go in.

2. Get the EIN

The EIN is free and issued immediately when you apply online with the IRS. The IRS page says you never have to pay a fee for an EIN and warns about sites that charge for one. Apply after Sunbiz accepts the filing, using the exact legal name. Keep the IRS confirmation letter: payers and the bank ask for it to prove the name and EIN match.

3. Get Type 1 and Type 2 NPIs

Every provider needs a Type 1 (individual) NPI and the practice needs a Type 2 (organization) NPI, both free from NPPES. A provider who trained in the U.S. usually has a Type 1 already; update its practice location and mailing address to the new practice. The Type 2 uses the entity's legal name and EIN. Pick taxonomy codes that match what you do. The difference, and where each number goes on a claim, is in NPI Type 1 vs Type 2.

4. Confirm Florida licensure for every provider

Each treating provider needs an active license from the Florida Department of Health board for the profession before any payer will enroll them. For an MD by examination, the Florida Board of Medicine lists a $350 application fee and a $355 initial license fee, plus a separate NICA fee ($250 or $5,000 unless exempt). The board says to expect a deficiency letter about 30 days after it receives the application, that no license issues without background check results, and that a license can take up to 10 business days to issue once the application is complete. Other professions apply to their own boards on their own fee schedules.

If you will do Level II or Level III office surgery, or liposuction removing more than 1,000 cc of supernatant fat, the office itself must register with the Department of Health and pass an inspection before registration (Fla. Stat. 458.328).

5. AHCA Health Care Clinic license, or confirm you are exempt

A Florida practice needs an AHCA Health Care Clinic license unless it fits one of the exemptions in Fla. Stat. 400.9905(4); most physician-owned practices fit (4)(g). The Health Care Clinic Act (Chapter 400, Part X) defines a clinic as an entity where health care services are provided to individuals and billed for. Exemption (4)(g), in the statute's words, covers "a sole proprietorship, group practice, partnership, or corporation that provides health care services" through licensed practitioners "and that is wholly owned by one or more licensed health care practitioners," or by a licensed practitioner together with a spouse, parent, child or sibling, provided a licensed owner "is supervising the business activities and is legally responsible for the entity's compliance."

If you need the license, the AHCA rule (59A-33.002) lists a nonrefundable $2,000 application fee, the statute caps the fee at $2,000 (400.9925), and 400.991 requires each clinic location to be licensed separately. Applications go through AHCA's Health Care Clinic unit, which also covers the medical or clinic director requirements and inspections.

If you are exempt, a certificate of exemption is voluntary under Rule 59A-33.006, and AHCA requires the fee with the application. Once you hold one, AHCA's exemption page says it must be renewed every two years, is valid only for the owners and location it was issued for, and needs a new application for a change of ownership or address. The exemption fee is not stated on the pages we read, so ask AHCA. Re-test the exemption every time an owner, location or management agreement changes.

6. DEA registration and Florida controlled-substance rules

If you will prescribe, administer or dispense controlled substances, register with the DEA after your Florida license is active; the practitioner fee is $888 for three years. The fee and period are in 21 CFR 1301.13. Under 21 CFR 1301.12, each principal place of practice needs its own registration, except an office where you only prescribe, keep no stock and are registered at another location in the same state. Moving your existing DEA registration to the new practice address is part of this step.

Florida adds two rules every prescriber at a new practice should build into the workflow:

• Check the PDMP before prescribing. Under Fla. Stat. 893.055(8), a prescriber or designee must review the patient's dispensing history in the state database before prescribing a controlled substance to a patient 16 or older, with narrow exceptions (nonopioid Schedule V, hospice, system outages).
• Two-hour controlled-substance course at every renewal. Fla. Stat. 456.0301 requires every DEA-registered prescriber to complete a board-approved 2-hour course on prescribing controlled substances at each license renewal.

7. Malpractice coverage (financial responsibility)

Florida requires physicians to show financial responsibility: at least $100,000 per claim and $300,000 aggregate, or $250,000 and $750,000 with hospital or surgery-center privileges. That is Fla. Stat. 458.320, which allows insurance, an escrow account or a letter of credit. Subsection (5)(g) lets a physician go without coverage by agreeing to pay adverse judgments up to set limits and posting a notice that begins "YOUR DOCTOR HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE." In practice, payers ask for a current certificate of insurance during credentialing, so bind coverage with an effective date on or before your first patient and upload the certificate to CAQH.

8. Build and attest the CAQH profile

CAQH is the free profile most commercial plans read for credentialing, and it must be complete and re-attested every 120 days. The 120-day cycle is in CAQH's provider quick reference guide. Enter the new practice location, upload the license, DEA certificate and malpractice certificate, authorize the plans you are applying to, and attest. How the profile works, and why a stale one stalls everything that reads it, is in What is CAQH?.

Before this step, gather everything at once. Our credentialing intake list is the packet we ask for on day one: licenses, DEA, malpractice, CV with month-and-year work history, W-9, NPIs and the Sunbiz and IRS letters.

9. Medicare enrollment in PECOS

File Medicare first among the payers, because you can bill only for services up to 30 days before your Medicare effective date. Under 42 CFR 424.520(d) that effective date is the later of the date you filed the approved application or the date you first furnished services at the new location. Applications go through PECOS: the CMS-855I for each provider, the CMS-855B for the group, a reassignment of each provider's benefits to the group, and the CMS-588 for electronic payments. In Florida the contractor is First Coast, which publishes a new-provider enrollment roadmap.

Physician and practitioner enrollments pay no Medicare application fee: the fee in 42 CFR 424.514 applies to institutional providers, and the definition excludes physician and nonphysician practitioner organizations. CMS holds contractors to processing 95 percent of online applications that need no site visit or development within 15 calendar days and all within 50 (Program Integrity Manual, ch. 10). Full walkthrough: Medicare provider enrollment.

10. Florida Medicaid, then the SMMC plans

Enroll with Florida Medicaid through AHCA first, then credential with each Statewide Medicaid Managed Care plan you want to bill. AHCA's provider readiness page says enrollment takes 60 days or less from a complete application and that deficiencies must be corrected within 21 days or the application is denied. Federal rules (42 CFR 438.602) require the state to screen and enroll every managed-care network provider, so the plans wait on the state. A deficiency letter mailed to an old address is the classic way a new practice loses those 21 days. Details: Medicaid provider enrollment and, plan by plan, the Florida credentialing timelines guide.

11. Commercial and Medicare Advantage plans

Apply to the commercial plans your patients actually carry, in parallel, once CAQH is attested. Our payer hub recommends this order for a new practice: Medicare, then Medicaid, then the commercial plans by patient mix. Medicare Advantage plans run their own credentialing under 42 CFR 422.204, separate from traditional Medicare, so each is its own application. Check that a plan contracts your provider type before you apply; some panels in some areas are closed. Each payer's own steps and published timeline are linked from the hub.

12. Bank account and merchant account

Open the business account in the entity's legal name under its EIN before you file Medicare, because the CMS-588 electronic-payment form and most payer EFT enrollments ask for it. A personal account, or a business account opened under a slightly different name, is a mismatch the payer will catch. Set up card processing for copays and patient balances at the same time so the front desk can collect on day one.

13. EHR, clearinghouse, and payer EDI enrollment

Choose the EHR and clearinghouse while the applications are pending, and enroll for electronic claims and ERAs with each payer as soon as you have its provider number. This is where we have stood in the room: installing an EHR in two practices and training one practice's staff on its system taught us that the software is rarely the problem. What breaks is the setup. Build the provider and location records with the same NPI, taxonomy and address the payers have; load the fee schedule before the first visit; and test a claim through the clearinghouse to each major payer before you rely on it. ERA enrollment is a separate step from claim enrollment, and without it payments arrive with no remittance to post.

14. Billing setup

Decide before the first visit who sends claims, who posts payments, who works denials and who reports A/R each month. If you bill in house, you need those four jobs covered and a timely-filing calendar for each payer. If you outsource, ClaimCarePro charges 6% of collections with a $1,000 monthly minimum, month-to-month, no setup fee. The comparison is in in-house biller vs outsourced RCM.

Which steps can run in parallel?

Almost everything after the license and NPIs can run at the same time; the one hard sequence is entity, then EIN, then Type 2 NPI, then payer applications. Practices that open late usually did the steps one at a time. The table shows the tracks we run together and the published clocks that govern them.

How long payer credentialing takes overall, payer by payer, is in how long does credentialing take.

What does it cost to start a medical practice in Florida?

The government fees to open a physician practice in Florida are a few thousand dollars and all published; rent, staff, equipment, insurance premiums and software are the real budget, and no agency publishes those. Every figure in the table is the agency's own published fee, read on 2026-10-23.

Not in the table on purpose: the AHCA certificate-of-exemption fee (not stated on the AHCA pages we read), office surgery registration (the statute charges the actual cost of registration and inspection), malpractice premiums, and any vendor price. What credentialing costs if you hire it out is on how much does credentialing cost.

Medical practice startup checklist

Print this and check each line off in order. Items on the same line can run together.

1. Advisors engaged (health care attorney, CPA); owners and entity type decided.
2. Sunbiz articles filed; certificate and legal name saved.
3. EIN issued; IRS letter saved. Business bank account opened in the legal name.
4. Type 1 NPIs updated to the new address; Type 2 NPI issued in the legal name.
5. Every provider's Florida license active; office surgery registration if applicable.
6. AHCA clinic license applied for, or exemption analysis written down (certificate optional).
7. DEA registration at the practice address; PDMP access set up; 2-hour course on the renewal calendar.
8. Malpractice bound with an effective date on or before day one; certificate in hand.
9. CAQH complete, documents uploaded, plans authorized, attested.
10. Medicare (855I, 855B, reassignment, 588) and Florida Medicaid filed the same week.
11. Commercial and Medicare Advantage applications filed together; SMMC plans after Medicaid ID.
12. EHR built with matching NPI, taxonomy and address; clearinghouse, EDI and ERA enrollment done; test claims sent.
13. Billing owner named for claims, posting, denials and monthly A/R; timely-filing calendar loaded.
14. Re-attestation, license, DEA and malpractice expirations on one calendar.

Where do new practices lose the most time?

In our experience it is bad data from the providers, not slow payers. A practice address on the NPI that differs from the license and CAQH. A deficiency letter mailed to a residency address. A malpractice certificate that expired between upload and review. A Type 2 NPI whose name does not match Sunbiz and the IRS letter. Each mismatch sends the file back to the start of a payer's review, and none of it shows up until weeks later. We log every payer follow-up weekly with the rep's name, the date and a reference number so nothing sits silently.

Where does ClaimCarePro fit?

We take the payer side off your plate while you build the rest. The new-practice credentialing bundle is $1,750 per provider ($1,400 each additional on the same group and payers) and covers CAQH, Medicare, Medicaid and six commercial payers. Single payer applications are $250 per payer per provider, CAQH setup is $250, re-credentialing is $250 and maintenance is $99 per provider per year. Billing, once you are open, is 6% of collections with a $1,000 monthly minimum, month-to-month, no setup fee. Our team brings 30+ years combined in medical billing. Full details: credentialing services.

Start credentialing now for a secure start link within one business hour, or call (844) 772-8902.

Frequently asked questions

Sources

All read 2026-10-23.

• Florida Division of Corporations: fees
• Florida Division of Corporations: file a Florida LLC
• Fla. Stat. 621.12: professional entity names
• IRS: get an employer identification number
• CMS NPPES and CMS NPI fact sheet
• Florida Board of Medicine: MD unrestricted license
• Fla. Stat. 400.9905: clinic definition and exemptions
• Fla. Stat. 400.991: license per location and 400.9925: fee cap
• Fla. Admin. Code 59A-33.002: clinic license application fee
• Fla. Admin. Code 59A-33.006: certificates of exemption
• AHCA: Health Care Clinics and exemption from licensure
• Fla. Stat. 458.328: office surgeries
• Fla. Stat. 458.320: financial responsibility
• 21 CFR 1301.13: DEA fees and periods and 1301.12: separate registrations
• Fla. Stat. 893.055: prescription drug monitoring program
• Fla. Stat. 456.0301: controlled-substance prescribing course
• CAQH provider quick reference guide
• CMS PECOS, CMS-588 and First Coast new-provider roadmap
• 42 CFR 424.502, 424.514 and 424.520
• CMS Program Integrity Manual, chapter 10
• AHCA: Medicaid provider readiness and enrollment
• 42 CFR 438.602 and 42 CFR 422.204