How to start a medical practice in Florida

How do you start a medical practice in Florida?

File in this order, because most applications ask for something an earlier one produces:

1. Entity, then tax and practice numbers. Form the LLC or corporation on Sunbiz. The IRS issues the EIN online “in minutes for free,” in a session that “expires after 15 minutes of inactivity,” and the practice’s Type 2 NPI comes next in NPPES (NPI setup).
2. Licenses, alongside step 1. The Board of Medicine says an application and its fee are valid for one year.
3. The address. AHCA, the Certificate of Use and the CLIA application all name a location, so the lease comes before them.
4. Service filings. DEA registers a prescriber only after the Florida license, and an X-ray machine is registered within 30 days of acquiring it and before first use.
5. Payers, last. Medicare and commercial plans need the licenses, the NPIs and the address.

Every filing, with its agency and fee, is in the table on our start-a-practice service page.

In 2024, 42.2% of U.S. physicians worked in a practice wholly owned by physicians, 18 percentage points fewer than in 2012, and 11.9% practiced solo, down from 18.4% (AMA Physician Practice Benchmark Survey).

What should you decide before starting your own medical practice?

Sources: ss. 381.0098, 400.9905, 400.9935, 409.2576, 448.095 and 458.320, F.S.; Rule 64E-5.511, F.A.C.; 21 CFR 1301.12; CMS; Board of Medicine; Florida DFS; read Oct 20, 2026.

• Ownership. Paragraph (f) also lets a physician own the practice with a spouse, parent, child or sibling. Paragraph (g) extends the exemption to practices wholly owned by the other licensees it lists, from APRNs and dentists to chapter 491 therapists, if an owner who is a licensee “is supervising the business activities and is legally responsible for the entity’s compliance with all federal and state laws.” Whether a PA or PLLC suits your owners is a question for your attorney; AHCA licensing sets out the exemptions owner by owner.
• The optional certificate. An exempt practice may apply for AHCA’s Certificate of Exemption ($100 or less, valid up to 2 years, not transferable), but must first post its self-pay prices, covering at least its 50 most frequent services, on at least 15 square feet in the reception area (s. 400.9935(6)).
• Malpractice. The minimum is $100,000 per claim and $300,000 a year; physicians with hospital staff privileges, or who perform surgery in an ambulatory surgical center, need $250,000 and $750,000 (s. 458.320(1)–(2)). If a policy is cancelled and you can’t show compliance another way, DOH suspends the license (s. 458.320(4)(a)).

How much are medical practice startup costs in Florida?

For one physician-owner in the City of Miami with an MD license, an LLC, a CLIA waiver, one DEA registration and a biomedical waste permit, government fees alone come to $2,101, before NICA’s assessment ($250 or $5,000) and the City’s second invoice, for the inspections; a practice that needs the clinic license adds $2,300.

• X-ray: that is the medical rate, with $85 for each tube after the first; dental and podiatry machines cost $31 for the first tube and $11 for each other (Rule 64E-5.511(2)(c)).
• Deadlines that raise the price: the biomedical waste permit costs $105 if the application arrives after Oct 1, and the LLC’s annual report, due by May 1, rises from $138.75 to $538.75.

Rent, staff, equipment, malpractice premiums and software cost more, and no primary source read for this guide publishes them: get written quotes before you sign a lease.

How long does opening a medical practice take?

• DOH: a license application must be approved or denied within 90 days after DOH receives it complete (s. 120.60(1)). On Oct 20, 2026, the Board of Medicine’s dashboard showed 18 days for current initial review of MD applications; across all professions, DOH averaged 51.56 business days to issue an initial license to a qualified applicant in FY 2024–25.
• AHCA, if you need the license: it flags errors within 30 days of receiving the application and decides within 60 days after it is complete (s. 408.806(3)(a), (c)).
• Medicare: First Coast’s published timeframes are 50 days for every clean online (PECOS) application and 85 when it needs a site visit, more information or fingerprints. Your effective date is the later of the filing date and the day you first see patients at the location (42 CFR 424.520(d)); Medicare enrollment covers the forms.
• Commercial plans: published timelines run from 30 days (Humana) to 90 (Evernorth), and loading the contract adds more (Cigna: about 10 business days); credentialing explained compares the plans.

Florida Medicaid’s effective date works differently:

“The enrollment effective date is the date the agency receives the provider application.”

What are the requirements to open a medical clinic in Miami?

Under s. 400.9905(4), any entity that provides health care services and charges for them is a clinic unless an exemption applies. A licensed clinic appoints a medical or clinic director who accepts, in writing, legal responsibility for duties that run from checking that every practitioner holds “a current active and unencumbered Florida license” (verify a license) to reviewing referral contracts and billing (s. 400.9935(1)).

• City of Miami: the City contacts you within 5 business days of your Certificate of Use application, and the inspections must finish within 90 working days of the application start date, “or you will have to start over (and pay again).” A second invoice brings the Fire and Code Enforcement inspection fees, and other agencies bill their inspections separately. The certificate lasts to the end of the City’s fiscal year, Sept 30.
• Unincorporated Miami-Dade: a Certificate of Use and Occupancy, in addition to the county’s business tax receipt.

What you can do today: a checklist for starting a medical practice

1. List every owner and the license each holds, and ask your attorney which s. 400.9905(4) paragraph, if any, fits.
2. Mark the services you will offer on day one and copy each matching filing from the decisions table into your calendar.
3. Call the city’s zoning office before you sign a lease and ask what the Certificate of Use inspections will check at that address.
4. Apply for each clinician’s license online with every document attached: the Board of Medicine mails its deficiency letter about 30 days after it receives an application.
5. Ask malpractice carriers for quotes at the s. 458.320 limits that match your hospital privileges.

Advixor helps new practices open: it prepares AHCA license and exemption applications and handles initial enrollment and credentialing with commercial health plans, Medicare and Medicaid (start a practice).