Florida

Board

of

Medicine

A license with the current status of inactive or retired can be “reactivated” at any time by contacting the Board of Medicine in writing. You may submit the request by emailing BOM_PostLicensure@flhealth.gov or by mailing the request to our office. The requirements to reactivate a license are checked individually for each licensee. The Board office will contact the requester with the individual requirements for fees and CMEs that would need to be completed for reactivation of an inactive or retired license holder.

General requirements to reactivate a license are:

• Fees for reactivation
• Proof of completing all required CME for each year of inactive or retired status.
• Completed Health History Questions and Financial Responsibility form within the reactivation packet.

Any physician whose license has been inactive or retired, who has not practiced for 2 years out of the previous 4 years in another jurisdiction, shall be required to appear before the Credentials Committee of the Board and establish the ability to practice with the skill and safety sufficient to protect the health, and welfare of the public. At the time of appearance, the physician must:

• Demonstrate compliance with 1 through 3 above.
• Demonstrate successful completion of the SPEX exam with a score of at least 75 achieved within the year prior to the appearance before the Credentials Committee. For information about the SPEX please log onto the Federation of State Medical Boards website at www.fsmb.org.
• Account for any activities related to the practice of medicine during the period that the license was on retired status or not practicing in another jurisdiction and establish an absence of malpractice or disciplinary actions pending in any jurisdiction.

The Department shall refuse to reactivate the retired status license of a physician who is under investigation or prosecution in any jurisdiction for an action that would constitute a violation of chapter 458, FS or the professional practice acts administered by the department and the boards, until 15 days after the Department receives the final results of the investigation or prosecution.

In accordance with section 456.44(2), Florida Statutes, an allopathic physician licensed under Chapter 458, an osteopathic physician licensed under Chapter 459, a podiatric physician licensed under Chapter 461, a dentist licensed under Chapter 466, a physician assistant licensed under Chapter 458 or Chapter 459, or an advanced registered nurse practitioner certified under part I of Chapter 464 who prescribes any controlled substance listed as Schedule II, Schedule III, Schedule IV or Schedule V narcotics as defined in s. 893.03, for the treatment of chronic nonmalignant pain, must designate himself or herself as a controlled substance prescribing practitioner on the practitioner profile.
To designate oneself as a controlled substance prescribing practitioner as provided in section 456.44, Florida Statutes:
Visit our secure “Online Services” website at: https://mqa-vo.doh.state.fl.us/datamart/voservicesportal
If you have not created an account in our new Online Services Portal, click “No” and follow the instructions provided to complete your one-time account registration.
In you have already created an account, click “Yes” and log in using your MQA Online Services user ID and password. This is the same user ID and password used to renew your license online.
Under the “Manage My License” section, select “Controlled Substance Prescribing” and follow the instructions to indicate you are a prescriber of controlled substances for the treatment of chronic nonmalignant pain.
Note: The online system can assist you if you do not remember your login ID or password. If you are unable to login please call 850-488-0595 and a representative will assist you.
“Chronic nonmalignant pain” is defined as pain unrelated to cancer which persists beyond the usual course of disease or the injury that is the cause of the pain or more than 90 days after surgery.

Log into your MQA Online Services Portal account and select Request Duplicate License from the “Manage My License Information” pulldown menu. Review your changes and click “Submit.”  

NOTE: Your license should be retrievable through the MQA Online Services Portal within 2 business days after your order is complete. If your profession is pending renewal or in a current renewal cycle, you may be asked to renew your license instead of being issued a duplicate license. 

For Current Licensees:

Login to your MQA Online Services Portal account, select Request Address Change from the “Manage My License” pulldown menu, make the necessary changes and click “Submit” to complete your update.
Note: You will receive a summary page that displays the updated address. The Division of Medical Quality Assurance is now issuing electronic licenses, which enables you to download a PDF copy of your license within two business days. The license can be retrieved in the License Documents menu of your MQA Online Services Portal, https://mqa-vo.doh.state.fl.us/datamart/voservicesportal account. To learn more, please visit the electronic licensing webpage at https://flhealthsource.gov/electronic-licensing/. Please see “How do I obtain a duplicate license”.

About Your Practice Location Address
The practice location address will display on the Internet and your license. Your practice location must be a physical location address and must not include a Post Office box. The mailing address will only display on the Internet if you have not provided a practice location address to the Department.

Establishment/Facility Name or Address
If the name or address change is for a facility that has changed location, a licensure application must be submitted. See your profession’s web page for additional information.

For New Applicants:

Contact your application processor to notify him/her of the change. If you do not know who your processor is, or do not know how to contact your processor, please e-mail us at info@flboardofmedicine.gov. Please be sure to include your file number or application number, the address currently listed on your application, and the address to which you would like to have your file changed.

Log into your MQA Online Services Portal account and select Request Inactive Status from the “Manage My License” pulldown menu.

After Expiration:

Log into your MQA Online Services Portal account and select Request Inactive Status after Expiration Date from the “Manage My License” pulldown menu.

NOTE: Your inactive status license must be renewed prior to the expiration date. Reactivation of your license will require verification that you have completed the required continuing education during the period since your last active renewal. Licenses that have been inactive for over 4 years must provide proof of the practice of medicine during their inactive status. Employment does not have to have been in Florida. Licensees who have been inactive for over 4 years and have not practiced medicine during that time must complete the SPEX exam. If the license is not renewed after two consecutive biennial licensure cycles, the license will expire and the physician will have to reapply for licensure meeting the current licensure requirements.

Log into your MQA Online Services Portal account and select Request Retired Status during renewal or Request Retired Status after Expiration Date outside of renewal from the “Manage My License” pulldown menu.

The retired status license cannot and does not need to be renewed by the normal renewal process and you will no longer receive notifications from the Department of Health. Please be aware that physicians choosing to change the retired status to active status will be required to pay all past renewal fees, enter into CE Broker all continuing medical education credits from each biennium since the license was last renewed and, if the physician has not practiced within the past 5 years, complete the Special Purpose Examination (SPEX) given by the Federation of State Medical Boards will be required for reactivating the license.

Licensure Data and Profile Data are available for download at no charge from the Department of Health’s website.

Name changes require legal documentation showing the name change. To change your name, please submit supporting documents, which must be one of the following:

1. A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court.
2. A divorce decree restoring your maiden name.
3. A court order showing the name change (adoption, legal name change, federal identity change).
4. A copy of a certificate of naturalization or H1B Employment Visa (Note: Foreign applicants and/or licensees may not have state issued documents)

Any one of these will be accepted unless the department has a question about the authenticity of the document.

The Division of Medical Quality Assurance is now issuing electronic licenses, which enables you to download a PDF copy of your license within two business days. The license can be retrieved in the License Documents menu of your MQA Online Services Portal, https://mqa-vo.doh.state.fl.us/datamart/voservicesportal account. To learn more, please visit the electronic licensing webpage at https://flhealthsource.gov/electronic-licensing/.

For requests by mail, please include your full name as it appears on your license, profession, license number, your new name, your date of birth, the last four digits of your social security number, and your signature. Please submit your name change along with supporting document(s) 5-7 business days to allow processing if you need to renew online.

If you do not require a new license to reflect your new name, you may submit your request online or by mail along with legible supporting document(s) to one of the following:

•  Log onto your MQA Online Services Portal account , select “Request Name Change” from the “Manage My License” dropdown menu
• Mailing address – DOH, Division of Medical Quality Assurance, Post Office Box 6320, Tallahassee, Florida 32314-6320

Dispensing is defined as selling medicinal drugs to patients in the office. A practitioner who writes prescriptions or provides complimentary professional samples is not a “dispensing practitioner,” and therefore does not need to register with the department.

A practitioner authorized by law to prescribe drugs may dispense such drugs to her or his patients in the regular course of her or his practice in compliance with s. 465.0276, Florida Statutes.

Duly authorized agents and employees of the department shall inspect in a lawful manner at all reasonable hours any pharmacy, hospital, clinic, wholesale establishment, manufacturer, physician’s office, or any other place in the state in which drugs and medical supplies are manufactured, packed, packaged, made, stored, sold, offered for sale, exposed for sale, or kept for sale for the purpose of:

(a) Determining if any of the provisions of this chapter or any rule promulgated under its authority is being violated;
(b) Securing samples or specimens of any drug or medical supply after paying or offering to pay for such sample or specimen; or
(c) Securing such other evidence as may be needed for prosecution under this chapter.

To print a Dispensing Practitioner Form online, click “Forms & Requests” on the Resources page.

Fees:
Registration      $100
Renewal      $100

Mail the completed Dispensing Practitioner Form and $100 Fee* to:

Department of Health
Division of Medical Quality Assurance
Board of Medicine
PO Box 6320
Tallahassee, FL 32314-6320

* Cashier’s check or money order is required payable to Department of Health. Do not send cash.

Additional information regarding Dispensing Practitioners can be found at s. 465.0276, s. 465.017, F.S and Rule 64B8-3.006, FAC.

There are two types of license relinquishments, administrative and disciplinary. Rule 64B8-8.018, FAC provides that a Florida licensee may administratively relinquish the license at any time, provided there is:

• no investigation against the license already initiated;
• no investigation against the license anticipated;
• no disciplinary action against the license pending; and
• not current restrictions against the license by the Board of this state or any other jurisdiction

This type of administrative relinquishment shall not be considered disciplinary action against the license as that term is used in Section 458.331(1)(b), Florida Statutes.

Click here to request a Voluntary Relinquishment Form.  Mail the completed Voluntary Relinquishment Form to:

Department of Health
Division of Medical Quality Assurance
Board of Medicine
4052 Bald Cypress Way, Bin C03
Tallahassee, FL 32399-3253

If a licensee wishes to voluntarily relinquish a license, but the licensee or the license is currently under any of the constraints set forth above, then the licensee may relinquish the license only with the approval of the Board of Medicine. If the voluntary relinquishment is accepted by the Board of Medicine, then the acceptance of the voluntary relinquishment of the license shall be considered disciplinary action against the license as that term is used in Section 458.331(1)(b), Florida Statutes, and shall be reported as such by the Board of Medicine. In addition, the licensee will be required to cease practice immediately upon signing the voluntary relinquishment and agrees to never reapply for licensure in Florida again

How do I report an adverse incident?

Section 458.351, Florida Statutes, requires any adverse incident that occurs on or after January 1, 2000, in any office maintained by a physician for the practice of medicine which is not licensed under chapter 395 be reported to the department.

Adverse incidents must be reported within 15 days after the occurrence of the adverse incident.

Click here to print an Adverse Incident Form.

Mail the completed Adverse Incident Form by certified mail to:

Department of Health
Consumer Services Unit
4052 Bald Cypress Way, Bin C75
Tallahassee, FL 32399-3275

For purposes of notification to the department, the term adverse incident means an event over which the physician or licensee could exercise control and which is associated in whole or in part with a medical intervention, rather than the condition for which such intervention occurred, and which results in the following patient injuries:

(a) The death of a patient.
(b) Brain or spinal damage to a patient.
(c) The performance of a surgical procedure on the wrong patient.
(d) 1. The performance of a wrong-site surgical procedure;
2. The performance of a wrong surgical procedure; or
3. The surgical repair of damage to a patient resulting from a planned surgical
procedure where the damage is not a recognized specific risk as disclosed to the
patient and documented through the informed-consent process if it results in: death;
brain or spinal damage; permanent disfigurement not to include the incision scar;
fracture or dislocation of bones or joints; a limitation of neurological, physical, or
sensory function; or any condition that required the transfer of the patient.
(e) A procedure to remove unplanned foreign objects remaining from a surgical procedure.
(f) Any condition that required the transfer of a patient to a hospital licensed under chapter 395 from an ambulatory surgical center licensed under chapter 395 or any facility or any office maintained by a physician for the practice of medicine which is not licensed under chapter 395.

Additional information regarding Adverse Incidents can be found at s. 458.351, F.S., and Rule 64B8-9.001, F.A.C.

Each year the Department of Health contracts with experts to review cases against medical professionals who may have failed to provide appropriate medical care such as is expected of a medical practitioner in the State of Florida. Being an expert witness for the Department not only helps to improve the efficiency of the disciplinary process, but also allows you to play an active role in helping to regulate your profession.

Experts must:

• Have a current Florida license;
• Be actively practicing in Florida;
• Shall not have ever been the subject of any disciplinary action by the medical licensing authority of any state or jurisdiction, and is currently; and
• Shall remain in good standing with the respective healthcare profession for which his or her services are required.

The Department offers two types of expert witness contracts.

• If you wish to provide your services pro bono, Board rules provide an official recognition for time spent in the review of a case and written opinion by awarding Continuing Medical Education (CME) Credits of 5.0 hours per case, up to a maximum of 15 hours per biennial license renewal period towards risk management. For services other than case review and written opinion, such as deposition and trial services, you will be compensated at a modest rate of $160.00 per hour.
• If you wish to be a paid expert, you will be compensated at a modest rate of $125.00 per hour for time spent in the review of a case and written opinion and $160.00 for deposition and trial services. Your deposition testimony would typically be paid by the opposing counsel at your requested fee.
• Additionally, the Department reimburses travel expenses in accordance with the Department of Health 40-1 (Official Travel of Department of Health Employees and Non-Employees.)

If you are interested in becoming an expert witness for the Department and your board, please click on the link below to fill-out and submit your application:

Apply Online →

If you are a physician licensed in another state but do not hold a Florida medical license, and you plan to provide expert witness testimony in Florida, you must register for an Expert Witness Certificate. For more information, click on Apply located on this page.

A physician must submit notice to the Board when he/she enters into

• A formal supervisory relationship or standing orders with an emergency medical technician or paramedic licensed pursuant to s. 401.27, which relationship or orders contemplate the performance of medical acts, or
• An established protocol with an advanced registered nurse practitioner, which protocol contemplates the performance of medical acts identified and approved by the joint committee pursuant to s. 464.003(2) or acts set forth in s. 464.012(3) and (4), the physician shall submit notice to the board.

The physician shall file notice within 30 days of entering into the relationship, orders or protocol. Notice shall also be filed within 30 days after terminating the relationship, orders, or protocol

APRN/EMT/Paramedic Protocol (PDF)

Mail the completed Protocol Form to:

Department of Health
Division of Medical Quality Assurance
Board of Medicine
4052 Bald Cypress Way, Bin C03
Tallahassee, FL 32399-3253
(850) 488-0596 FAX

Additional information regarding protocols can be found at s. 458.348, F.S.

As a condition of licensing and maintaining an active license, and prior to the issuance or renewal of an active license or reactivation of an inactive license for the practice of medicine, an applicant must demonstrate to the satisfaction of the board and the department, financial responsibility to pay claims and costs ancillary thereto arising out of the rendering of, or the failure to render, medical care or services.

The licensee must notify the Board in writing of any change of status relating to financial responsibility compliance or exemption at least 10 calendar days prior to the change. In addition, the licensee is required to maintain such written documentation as may be necessary to prove his/her compliance with or exemption from financial responsibility requirements for a period of not less than 7 years.

Financial Responsibility options are divided into two categories, coverage and exemptions, pursuant to s. 458.320, Florida Statutes.

Using the Financial Responsibility Form, you will select only one option of the ten provided:

Coverage Options

1. I do not have hospital staff privileges and I have obtained and maintain professional liability coverage in an amount not less than $100,000 per claim, with a minimum annual aggregate of not less than $300,000 from an authorized insurer as defined under s.624.09, F. S., from a surplus lines insurer as defined under s. 626.914(2), F.S., from a risk retention group as defined under s. 627.942, F.S., from the Joint Underwriting Association established under s. 627.351(4), F. S., or through a plan of self-insurance as provided in s. 627.357, F.S. 2.
2. I have hospital staff privileges and I have professional liability coverage in an amount not less than $250,000 per claim, with a minimum annual aggregate of not less than $750,000 from an authorized insurer as defined under s. 624.09, F. S., from a surplus lines insurer as defined under s. 626.914(2), F. S., from a risk retention group as defined under s. 627.942, F.S., from the Joint Underwriting Association established under s. 627.351(4), F. S., or through a plan of self insurance as provided in s.627.357, F .S.
3. I do not have hospital staff privileges and I have established an irrevocable letter of credit or an escrow account in an amount of $100,000/$300,000, in accordance with Chapter 675, F. S., for a letter of credit and s. 625.52, F. S., for an escrow account.
4.  I have hospital staff privileges and I have established an irrevocable letter of credit or escrow account in an amount of $250,000/$750,000, in accordance with Chapter 675, F. S., for a letter of credit and s. 625.52, F. S., for an escrow account.
5.  I have elected not to carry medical malpractice insurance, however, I agree to satisfy any adverse judgments up to the minimum amounts pursuant to s. 458.320(5)(g) 1 or 459.0085(5)(g)1, F. S. I understand that I must either post notice in the form of a “sign” prominently displayed in the reception area or provide a written statement to any person to whom medical services are being provided that I have decided not to carry medical malpractice insurance. I understand that such a sign or notice must contain the wording specified in s. 458.320(5)(g) or 459.0085(5)(g), F. S.

Exemptions

1. I practice medicine exclusively as an officer, employee, or agent of the federal government, or of the state or its agencies or subdivisions. For the purposes of this subsection, an agent of the state, its agencies, or its subdivisions is a person who is eligible for coverage under any self-insurance or insurance program authorized by the provisions of s.768.28 (16).
2. I hold a limited license issued pursuant to s. 458.317 or 459.0075, F. S., and practice only under the scope of the limited license.
3. I do not practice medicine in the State of Florida. I understand that if I resume any practice of medicine in this state, I must notify the department of such activity and fulfill the financial responsibility requirements of Chapters 458, or 459, F.S. before resuming the practice of medicine in the State of Florida.
4. I meet all of the following criteria:
   1. I have held an active license to practice in this state or another state or some combination thereof for more than 15 years.
   2. I am retired or maintain part time practice of no more than 1000 patient contact hours per year.
   3. I have had no more than two claims resulting in an indemnity exceeding $25,000 within the previous five-year period.
   4. I have not been convicted of or plead guilty or nolo contendere to any criminal violation specified in Chapter 458 or 459, F. S.
   5. I have not been subject, within the past ten years of practice, to license revocation or suspension, probation for a period of three years or longer, or a fine of $500 or more for a violation of Chapter 458 or 459, F.S., or the medical practice act of another jurisdiction. A regulatory agency’s acceptance of a relinquishment of license stipulation, consent order or other settlement offered in response to or in anticipation of filing of administrative charges against a license shall be construed as action against a license. I understand if I am claiming an exception under this section that I must either post notice in the form of a sign, prominently displayed in the reception area or provide a written statement to any person to whom medical services are being provided, that I have decided not to carry medical malpractice insurance. I understand such a sign or notice must contain the wording specified in s. 458.320(5) (f)7 or 459.0085(5)(f)7, F. S.
5. I practice only in conjunction with my teaching duties at an accredited medical school or its teaching hospitals. I understand that I may practice medicine to the extent that such practice is incidental to and a necessary part of my duties in connection with my teaching position in the medical school. (Interns and residents do not qualify for this exemption).

Section 458.351, Florida Statutes provides for the optional use of an Informed Consent Form for Cataract Operation with or without Implantation of Intraocular Lens developed and approved by the Boards of Medicine and Osteopathic Medicine.

As provided in Rule 64B8-9.017, Florida Administrative Code the Board-approved informed consent form is not executed until:

1. The physician performing the surgery has explained the information in the consent form to the patient. Such physician is prohibited from delegating this responsibility to another person. The physician performing the surgery is also required to sign the informed consent form;
2. The patient or the person authorized by the patient to give consent is required to sign the informed consent form; and
3. A competent witness is also required to sign the informed consent form.

Cataract Operation Informed Consent (PDF)

Additional information regarding the use of the informed consent form can be found at Rule 64B8-9.017, FAC and s.458.351, FS.

1. Login to online services by selecting your profession from the dropdown menu and entering your User ID and Password. The survey must be completed by allopathic and osteopathic physicians only.

• Your User ID and Password were mailed with your initial license. Please look at the center section and refer to the Online Services Instructions, item #5.
• If you do not have your User ID and Password, click on “Get Login Help“.

2. Select “Physician Workforce Survey” on the left side of the page

3. Complete Physician Workforce Survey

You can view, confirm, or make changes to the information that will be published in your practitioner profile . In carrying our legislative mandate to publish practitioner profiles, we want to ensure the information that we publish is accurate. Accordingly, we ask that you please review your profile for any changes, corrections, and/or omissions. If you see the statement “The practitioner did not provide this mandatory information”, please provide that information. We will not accept curriculum vitae or resumes in place of you providing specific information. Changes, excluding education and training, year began practicing, and liability claims, can be made to your profile electronically by following the instructions below. You may also submit changes by mail to:

Department of Health
Licensure Support Services
4052 Bald Cypress Way, Bin C-10
Tallahassee, Florida 32399-3260

Please note that Section 456.042, Florida Statutes, requires practitioners to update profile information within 15 days after a change of an occurrence in each section of your profile.

Attention Newly Licensed Practitioners
Section 456.041(7), Florida Statutes, requires you to submit changes to the department within thirty (30) days from receipt of this letter. If you do not make changes within thirty (30) days, your profile will be automatically published.

Once you have completed your review and made any necessary corrections, click on “Confirm Changes”. The Practitioner Confirmation Page will display the information that will be published online, at which time you must “Confirm” the profile again before the changes will be implemented.

Note: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.