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Medical Practice Startup Consultant: Start or Open a Practice in Florida
If you are weighing a medical practice startup consultant, start with timing: the 13 filings below wait on one another, and Medicare's effective date is the later of the day you file and the day you first see patients at the location (42 CFR 424.520(d)). We handle initial enrollment and credentialing with Medicare, Medicaid and commercial plans, and coordinate with your attorney on the legal questions.
The short answer
What does a medical practice startup consultant do?
Helps you sequence the 13 filings a new Florida practice makes, which wait on one another, starting with the entity on Sunbiz, and time credentialing: Medicare's effective date is the later of the day you file and the day you first see patients at the location. The Advixor Group handles initial enrollment and credentialing with Medicare, Medicaid and commercial plans, and coordinates with your attorney on the legal questions.
Sources42 CFR 424, subpart P
Every Filing
Start a medical practice in Florida: the filings, in order
| Filing | Agency | Government fee ($) | Needs first |
|---|---|---|---|
| Professional entity (PA or PLLC) | Division of Corporations (Sunbiz) | LLC 125, corporation 70; fictitious name 50 | — |
| EIN | IRS | 0 | Entity |
| Practitioner licenses | DOH boards | MD: 350 + 355 | — |
| Clinic license or exemption | AHCA | 2,000 + 300 per 2 years, or 100 for a certificate | Entity, director, Level 2 screening, location |
| Certificate of use (City of Miami) | City zoning, DERM, Fire, Code Enforcement | 50, plus inspections | Lease |
| City business tax receipt | City of Miami | Invoiced | Certificate of use, state licenses |
| County business tax receipt | Miami-Dade Tax Collector | By classification | State licenses, city receipt |
| NPI Type 2, plus a Type 1 per clinician | CMS (NPPES) | 0 | Entity, EIN |
| CLIA certificate, for any in-office test | CMS, through AHCA | Waiver 248, PPM 297 per 2 years | Location |
| DEA registration (Form 224), per prescriber, state and dispensing site | DEA | 888 per 3 years | Florida license |
| Medicare, group and each clinician | First Coast | 0 | NPIs, location |
| Florida Medicaid | AHCA | 0 for physicians, NPPs and Medicare-enrolled providers | Fully operational office |
| Commercial plans | Each plan | None published | Licenses, NPIs, malpractice coverage |
Sources Sunbiz; Board of Medicine; AHCA Form 3110-0013; City of Miami; Miami-Dade Tax Collector; IRS; CMS; 21 CFR 1301.13; 42 CFR 424.514, 455.460; Cigna; Evernorth; read Oct 17, 2026.
Your Entity
Starting a new business in Florida: entity, names and tax numbers
- Entity: a PA or PLLC may issue shares or admit members only to licensees (or professional corporations and PLLCs) authorized for “the same specific professional services” (s. 621.09), and its name must carry “chartered,” “professional association” or “P.A.”, or for a PLLC formed since 2014, “PLLC” or its long form (s. 621.12(2)).
- Names: you may not trade under a fictitious name until it is registered, and the registration runs to Dec 31 of the fifth year; AHCA and Miami-Dade both ask for it (s. 865.09).
- Annual reports: due May 1: $138.75 for an LLC, $150 for a corporation; $538.75 and $550 after.
- EIN: issued immediately online, one per responsible party per day, in a session that expires after 15 minutes of inactivity; you need that person’s SSN or ITIN.
Licenses
Medical practice startup licenses: DOH, AHCA, CLIA and DEA
The Department of Health works to the general licensing clock.
An MD license adds a NICA fee of $0, $250 or $5,000 by designation, and proof of financial responsibility, such as malpractice coverage of $100,000 per claim and $300,000 a year (s. 458.320).
- AHCA: a clinic that needs a license files Form 3110-0013 with proof of financial ability (Form 3100-0009) and the director’s attestation (Form 3110-1028).
- CLIA: Form CMS-116 goes to AHCA; CMS emails a fee notice with your CLIA number, you pay on pay.gov, and testing starts only once the certificate arrives. A waived lab’s director needs no federal qualifications.
- DEA: registering to prescribe Schedule II–V drugs requires one-time training of at least 8 hours on substance use disorders, unless, as a physician, you hold an addiction board certification, or you graduated in the last 5 years from a program that included 8 hours on it (21 U.S.C. 823(m)).
“An application for a license must be approved or denied within 90 days after receipt of a completed application unless a shorter period of time for agency action is provided by law.”
Local Steps
Local steps to start a business in Florida: Miami-Dade and the City of Miami
- City of Miami certificate of use: the City replies within 5 business days, and the DERM, Fire and Code Enforcement inspections must finish within 90 working days of starting, or you start over and pay the non-refundable $50 again. It expires every Sept 30.
- City receipt: it also asks for the EIN and each professional’s SSN and photo ID, and an interim receipt comes by email. Other cities set their own rules.
- County receipt: every applicant signs a declaration under s. 205.0532 on whether it does business with Cuba in violation of federal law (a knowingly false one is a third-degree felony). Printing takes up to 3 business days after that; operating without a required receipt adds a 25% penalty (s. 205.053(2)). Offices in unincorporated Miami-Dade also need a Certificate of Use and Occupancy.
Credentialing
Opening a new medical practice: credentialing before day one
Florida Medicaid gives you 21 days to fix a deficiency before it denies the application; Cigna adds about 10 business days to load an approval.
Sources DOH dashboard; s. 408.806(3), F.S.; First Coast; AHCA Medicaid readiness tool; Cigna; Evernorth; read Oct 17, 2026.
Employer Filings
Setting up a medical practice: employer filings and permits
- Workers’ compensation: required at 4 or more employees outside construction, counting corporate officers and LLC members (s. 440.02).
- New hires: reported within 20 days of each hire (s. 409.2576); with 25 or more employees, E-Verify too (s. 448.095).
- Biomedical waste: a DOH generator permit before opening unless the office makes under 25 pounds in 30 days ($85 by Oct 1, $105 after, yearly) (s. 381.0098).
- X-ray: apply to register each machine with DOH (DH Form 1107) within 30 days of acquisition and before use (Rule 64E-5.511(2)).
- Prescription drugs: an entity that buys them needs a DBPR Health Care Clinic Establishment permit ($255 every 2 years) and a designated practitioner.
- Pain management: DOH registration or a certificate of exemption if you advertise it or, in any month, most patients get opioids, benzodiazepines, barbiturates or carisoprodol for chronic nonmalignant pain (s. 458.3265).
Consultant or Attorney
What a medical practice startup consultant handles, and what stays with your attorney
Our medical practice startup consulting covers the payer, NPI, policy and hiring work in the cards further down, plus market research, a feasibility assessment and coordinated HIPAA, OSHA and fraud, waste and abuse training.
We prepare and submit the AHCA, CLIA, DEA and local filings.
The entity choice, operating agreement, lease and any purchase contract go to your attorney.
What’s included
What our physician practice start-up services include
CAQH and NPI
NPI registration and the CAQH profile commercial plans read.
Learn moreMedicare enrollment
Medicare enrollment, then revalidation when CMS asks.
Learn moreFlorida Medicaid enrollment
Florida Medicaid enrollment for the practice and its clinicians.
Learn morePayer enrollment
Commercial plan applications, plan by plan.
Learn moreCompliance
Policies, procedures and patient forms for the new office.
Learn moreHR and staff training
Recruiting (direct hire) and onboarding for your first staff.
Learn moreQuick answers
Questions for a medical practice startup consultant: NP and RN owners, buying, cost
Whether a nurse practitioner or a registered nurse can own the practice, buying one instead, what the government fees add up to and what to file first. For your own plan, ask us in a consultation.
Starting a nurse practitioner practice: can an NP open one in Florida?
Can a registered nurse open a clinic?
How do I buy a medical practice instead of starting one?
How much does it cost to open a medical practice in Florida?
What do I file first when starting a new medical practice?
Talk to an advisor
You care for patients. Who’s taking care of the business?
Tell us where your practice is today. We will tell you what we would do first.
Official sources
- Florida Statutes (2026), read Oct 17–19, 2026: ch. 621, ss. 120.60, 205.053, 205.0532, 381.0098, 400.9905, 400.9935, 408.806, 408.807, 409.2576, 409.907, 440.02, 448.095, 458.320, 458.3265, 464.0123, 627.736, 865.09
- Rules and federal law: Rule 64E-5.511, F.A.C., 42 CFR part 424, subpart P and 21 U.S.C. 823, read Oct 19, 2026; 42 CFR 455.460 and 21 CFR part 1301, read Oct 17, 2026
- Florida agencies, read Oct 17, 2026: Sunbiz LLC and corporate fees; Board of Medicine licensure and timing; DOH biomedical waste; AHCA Form 3110-0013, Medicaid policy and readiness tool; DBPR-DDC-224
- Local and federal agencies, read Oct 17, 2026: Miami-Dade tax receipt; City of Miami certificate of use and tax receipt; IRS EIN (read Oct 19, 2026); CMS NPI fact sheet, CLIA application and CLIA fees; DEA registration Q&A; First Coast timeframes; Cigna and Evernorth