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(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.)
E-mail us if you have questions.
Background Checks:
Q. How long does the background check take?
A. The process takes 48 hours.
Q. Is it possible to expedite the background check?
A. Unfortunately, there is no way to expedite the process. However, we now have scanners that allow us to scan the fingerprint cards and submit them electronically. This significantly shortens the waiting period.
Q. Can I call the Federal Bureau of Investigations (FBI) or the Florida Department of Law Enforcement (FDLE) about the status of my background check?
A. Neither the FBI nor the FDLE will be able to assist you. If you have any questions regarding your background check, please contact our office at (850) 245-4131.
Q. Where should I submit my fingerprints?
A. Please visit the Fingerprint Registration Site to register your demographic information. Once registered, you have the option of purchasing fingerprint cards ($4.00 for regular mail or $10.00 for priority mail). When you have completed your registration, a bar code receipt will be generated online. Print the receipt and mail your completed fingerprint cards to Florida Department of Health, 4052 Bald Cypress Way, Bin #C-02, Tallahassee, FL 32399-3252.
Q. Do I have to purchase fingerprint cards from the Florida Board of Medicine?
A. No. You are not required to purchase fingerprint cards from the Board of Medicine. However, you must make sure that the law enforcement agency or other agency you choose to roll your fingerprints uses a FD-258 Applicant Fingerprint Card (white card with blue ink). If the FD-258 is not used, your fingerprints will not be accepted, you will be required to have another set rolled, and your application will be delayed. If you choose not to purchase the fingerprint cards, you should still register your demographic information at theFingerprint Registration Site. When you have completed your registration, a bar code receipt will be generated online. Print the receipt and mail your completed fingerprint cards to Florida Department of Health, 4052 Bald Cypress Way, Bin #C-02, Tallahassee, FL 32399-3252.
Q. What information is required on the fingerprint cards?
A. Your name, social security number, date of birth, sex, race, height, weight, eye color, hair color, place of birth, and current residence are required.
Q. Where do I go to have my fingerprints taken?
A. You may get your fingerprints taken at any law enforcement location. Some hospitals or schools may also offer fingerprinting
Q. Am I still required to have my fingerprints taken if I hold a license in another state?
A. Yes, you are still required to undergo a Florida background check even if you hold a license in another state.
Q. Do you accept electronically scanned fingerprints?
A. Yes. Some police stations can electronically scan your fingerprints to the fingerprint cards, which you would then mail to us. (We do not accept fingerprints by fax or e-mail.)
Q. Can I hand-deliver my fingerprint cards to you?
A. Yes. You may bring your fingerprint cards to our office located at 4042 Bald Cypress Way, Tallahassee, FL 32399-3253.
Q. What happens if my fingerprints are rejected?
A. We will request that you have your fingerprints taken again.
Q. If my fingerprints are rejected, do I have to pay another background check fee?
A. No, you are not required to pay another fee.
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Fees/Refunds:
Q. Where should I send payment for my fees (application fee, background check fee, license fee, and NICA fee)?
A. Please send your payment to Department of Health, P.O. Box 6330, Tallahassee, Florida 32314-6330.
Q. If I reapply for licensure after my application expires, will the fees apply to my new application?
A. Only the initial license fee and the NICA fee will be applied to the new application. The application fee and the background check fee will not be applied to the new application.
Q. Will I get a refund if I am not approved for licensure?
A. We will refund your license fee and NICA fee. However, you will not receive a refund for your application fee or background check fee.
Q. Will I get a refund if my application expires?
A. You will get a refund for the initial license fee and the Neurological Injury Compensation Association (NICA) fee. However, you will not receive a refund for the application fee or the background check fee.
Q. I overpaid years ago. Can I still get a refund?
A. Yes, if the overpayment was made less than three years ago. There is a three year statute of limitation for refunds.
Q. How do I request a refund?
A. You must submit your request in writing. Mail your request to Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253. You may also fax your request to (850) 488-0596.
Q. How long will it take to receive my refund?
A. It can take up to four weeks to receive your refund.
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Financial Responsibility :
You are required to provide the Board of Medicine with information regarding your financial responsibility:
- when applying for initial licensure;
- upon licensure renewal; or
- whenever there is a change in your financial responsibility status.
To report a change in your financial responsibility status, please print and fill out the Florida Financial Responsibility form (pdf - 39kb). Mail the completed form to Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253. You may also fax the form to us at (850) 488-0596 or e-mail it to Shirley_Morss@doh.state.fl.us.
You may also review the following Florida Statutes for more information regarding financial responsibility requirements:
Q. What is Financial Responsibility?
A. The kind of insurance coverage you have at the time you are filling out your licensure application or renewal.
Q. Am I required to have professional liability coverage?
A. No. For more information regarding other financial responsibility options or exemptions, please see s. 458.320, F.S., and s. 459.0085, F.S.
Q. Do I need a bond of any kind?
A. There is no bond required. You may choose to demonstrate financial responsibility with an irrevocable letter of credit or an escrow account.
Q. Can I select more than one option for my financial responsibility?
A. No, you must select the one option that best describes your current financial responsibility situation.
Q. Am I required to send you a copy of my professional liability coverage policy?
A. You may be required to produce a copy of your policy if you are audited by the Licensing and Auditing Services Unit. However, you are not required to send a copy of your policy when applying for initial licensure.
Q. Am I required to inform the Board of Medicine if my professional liability coverage is changed or cancelled?
A. Yes. To report a change in your financial responsibility status, please print and fill out the Florida Financial Responsibility form (pdf - 39kb). Mail the completed form to Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253. You may also fax the form to us at (850) 488-0596 or e-mail it to Shirley_Morss@doh.state.fl.us.
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Licensure:
Q. Where do I send my application?
A. Please mail your application to Department of Health, P.O. Box 6330, Tallahassee, Florida, 32314-6330.
Q. Can I send letters of recommendation with my application?
A. Yes. You may send letters of recommendation with your application.
Q. Where should I send my required supporting documents?
A. Please mail all required supporting documents to Department of Health, 4052 Bald Cypress Way, BIN C03, Tallahassee, Florida, 32399-3253.
Q. Do I have to send all of my documents to the Board at the same time?
A. No. You are not required to send in all of your documents at the same time. However, we encourage you to send as much information as possible to help expedite the licensure process.
Q. Are documents required to be notarized?
A. No. Documents are not required to be notarized.
Q. Where should I send payment for my fees (application fee, background check fee, license fee, and NICA fee)?
A. Please send your payment to Department of Health, P.O. Box 6330, Tallahassee, Florida 32314-6330.
Q. Can I submit one check for all fees?
A. Yes. You may submit one check to cover all fees.
Q. Who is eligible for the reduced license fee?
A. You are eligible for the reduced license fee if you meet one of the following criteria:
- You are currently in an Accreditation Council for Graduate Medical Education (ACGME) training program or fellowship training program that leads to subspecialty certification
- You are a retired physician who maintains an active license but have withdrawn from the practice of medicine
- You are a physician who holds a limited license, as defined by s. 458.317, F.S., and do not receive any compensation for medical services
- You are a physician employed full time by the Veterans Administration (VA) and your practice is confined to VA hospitals
- You are a licensed physician on active duty with the Armed Forces of the United States
- You are a physician employed full time by the State of Florida, and your practice is confined to state-owned correctional institutions and state-owned mental health facilities
NOTE: As a result of paying the reduced fee, your license will reflect an “In-Training” status.
Q. Have you received my documents?
A. We will notify you within 30 days of receiving your application. You will receive your first notice which will include your user ID and pass code so you may also check the status of your application via our Online Application Status Check.
Q. What happens to my documents if you receive them before I submit my application?
A. Your documents will be placed in our repository database system until we receive your application.
Q. How can I expedite the licensure process?
A. You can expedite the licensure process by submitting all documents outlined in the application. If you are contacted by the Board staff to submit further documentation, please submit the documentation as soon as possible to Department of Health, 4052 Bald Cypress Way, Bin C03, Tallahassee, Florida 32399-33253.
Q. How long will it take to receive the printed copy of my license?
A. Upon licensure approval, your license number will be issued within seven to ten days. Please allow at least two to three weeks after approval to receive your printed license.
Q. Can I get a temporary license?
A. No. The Board of Medicine does not issue temporary licenses.
Q. Can I be granted an extension on an application after it has expired?
A. No. The Board of Medicine does not grant extensions on expired applications.
Q. Can I get a refund if I withdraw my application?
A. We will refund your license fee and NICA fee. However, you will not receive a refund for your application fee or background check fee.
Q. Am I required to pay the Florida Birth-Related Neurological Injury Compensation Association (NICA) fee?
A. You are required to pay the NICA fee unless you meet the following exemption criteria per s. 766.314, F.S.:
- Resident physicians, assistant resident physicians and interns in postgraduate training programs approved by the Board of Medicine
- Retired physicians who maintain an active license, but who have withdrawn from the practice of medicine
- Physicians who hold a limited license, as defined by s. 458.317, F.S., who do not receive any compensation for medical services
- Physicians employed full-time by the Veterans Administration whose practice is confined to VA hospitals
- Any licensed physician on active duty with the Armed Forces of the United States
- Physicians employed full-time by the State of Florida whose practice is confined to state-owned correctional institutions and state-owned mental health facilities
Proof of qualification for a claimed exemption must be submitted to NICA, P.O. Box 14567, Tallahassee, FL 32317-4567. Please contact NICA at (850) 488-8191 for further information or visit their website.
Q. Am I required to show verification of an expired or past medical license?
A. Yes. You must get verification of all current and/or expired medical licenses when applying for a medical license in the state of Florida.
Q. What is required as proof of training?
A. A copy of your postgraduate training certificate(s) is required as proof of training. We will also accept a letter from the current program director/chairman, addressed to the Florida Board of Medicine, listing the beginning and ending dates of training and post graduate year level(s) completed.
Q. Who should complete my Post-Graduate Training Evaluation and staff privilege forms?
A. You should send a Post-Graduate Training Evaluation form to each institution where you did internship, residency or fellowship training and the staff privilege form to any hospitals where you have current staff privileges. The training evaluation form should be signed by the current program chairman or director. The staff privilege verification form should be completed by the Chief of Staff.
Q. I am an International Medical Graduate and did my core clerkships in the US but didn’t do my core clerkship in Accreditation Council for Graduate Medical Education (ACGME) approved programs. Are they still acceptable?
A. No. However, you will satisfy this deficiency after you have three years of training in one specialty area. Please review Rule 64B8-4.018, F.A.C. for further details.
Q. I took my exams a long time ago. Am I required to take them again?
A. An unrestricted medical license in Florida requires one of the following examinations:
- Federation Licensing Examination (FLEX), National Boards or United States Medical Licensing Examination (USMLE): no time limit. Please review s. 458.313, F.S., or s. 458.311, F.S., for further details.
- State Board Examination prior to 1974: 20 years active licensed practice and three (3) current state medical licenses. Please review s. 458.311, F.S., for further details.
- State Board Examination after 1974: 10 years active licensed practice, one (1) current state medical license and passage of the Special Purpose Examination (SPEX) examination. Please review s. 458.311, F.S., for further details.
Q. What if my documents no longer exist?
A. You may be required to file a Petition for Waiver/Variance and meet with the Board at a Credentials Committee meeting. Please contact the Board at (850) 245-4131 for further information.
Q. The school/institution I attended no longer exists and I am unable to obtain copies of my school transcripts. What do I do?
A. Send details regarding the closure of your school/institution with your application. Please include the following:
- Name of school/institution
- Address of school/institution
- Date of closure (if known)
- Dates of attendance
Q. I am unable to obtain required documents from Cuba. What do I do?
A. Send details regarding your attempts to obtain documents from Cuba with your application. Please include the following:
- Name of school/institution
- Address of school/institution
- Dates of attendance
Q. I appeared before the Credentials Committee. What should I do now?
A. Unless otherwise instructed, please submit the information required by the Credentials Committee and wait for the Board to approve your license at the next available Board meeting.
Q. Do you accept credentialing verification from Federal Credentials Verification Services (FCVS)?
A. Yes. The Florida Board of Medicine accepts credentialing verification from FCVS.
Q. What will Federal Credentials Verification Services (FCVS) provide to the Board?
A. FCVS obtains and provides primary source verification of medical education, postgraduate training, licensure examination history, board action history, board certification, identity, Educational Commission for Foreign Medical Graduates (ECFMG) Certification, and ECFMG Certification Status Report. Although FCVS will assist with the licensure process, you are not required to use their services. For more information about FCVS, please visit their website.
Q. Does Federal Credentials Verification Services (FCVS) verify undergraduate education?
A. No. FCVS does not verify undergraduate education.
Q. If I use the Federal Credentials Verification Services (FCVS), will it expedite the licensure process?
A. Yes. If FCVS has completed the credentials verification of your core credentials, it will expedite the licensure process.
Q. What criminal offenses am I required to report to the Board?
A. You are required to report all criminal offenses to the Board. You must know and comply with the following laws and rules as they pertain to your profession:
Q. Do I have to report any criminal activities after I receive my medical license?
A. Yes. You are required to report all criminal activities after you receive your medical license. You may report the criminal offense(s) online via Online Services, by e-mail (Licensure_Services@doh.state.fl.us), or by mail to Florida Department of Health, Licensing and Auditing Services Unit, Bin #C-10, Tallahassee, FL 32399-3267. If reporting by e-mail or mail, provide the date of the offense, a description of the crime, and the county and state of jurisdiction.
Q. How many times can I take the United States Medical Licensing Examination (USMLE)?
A. There is no limit on attempt and there is no limit on the amount of time it takes you to complete the test.
Q. What is Educational Commission for Foreign Medical Graduates (ECFMG) Certification and what is an ECFMG Status Report?
A. Medical schools outside the United States and Canada vary in their educational standards and curricula. The purpose of ECFMG Certification is to assess the readiness of international medical graduates to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To be certified by ECFMG, you must pass a series of exams and must also fulfill ECFMG’s medical education credential requirements. These requirements include providing ECFMG with copies of your medical education credentials, which ECFMG will verify directly with your medical school(s). Additionally, your medical school must be listed in the International Medical Education Directory (IMED). The ECFMG Certification Status Report will confirm your certification status and is required for all international medical graduates seeking licensure in the State of Florida. For more information regarding ECFMG, please visit their website or contact them at (215) 386-5900.
Q. Is ECFMG Certification required?
A. ECFMG Certification is required of all international medical graduates seeking licensure in the State of Florida.
Q. How can I find out if my medical school is listed in the International Medical Education Directory (IMED)?
A. You may search IMED’s database online or contact them at (215) 823-2105. If your school is not listed in the IMED database, please contact the Board of Medicine at (850) 245-4131.
Q. My medical school is not listed in the International Medical Education Directory (IMED). How can I get it listed?
A. Contact the Educational Commission for Foreign Medical Graduates (ECFMG) at (215) 386-5900 to learn about certification requirements.
Q. Why does my license show an “In-Training” status when I am not In-Training any longer? How can I get the “In-Training” status removed from my license?
A. If you were In-Training at the time of your application, your license will show an “In-Training” status. Also, if you paid the reduced license fee, your license will show an “In-Training” status. To remove the “In-Training” status, please either send a copy of your completion certificate or a letter from your Program Director stating you have completed your training program or pay the full fees, including the Neurological Injury Compensation Association (NICA) fee.
Q. Does “In-Training” status limit my scope of practice?
A. No. It does not limit your scope of practice, but it might limit where you can be employed. Some facilities will not hire doctors with the “In-Training” status on their license.
Q. How do I get a DEA (Drug Enforcement Agency) number?
A. Please contact the DEA at (800) 882-9539 or visit their website.
Q. Is a DEA (Drug Enforcement Agency) number required to write prescriptions for controlled substances in the State of Florida?
A. Yes. A DEA number is required to write prescriptions for controlled substances in the State of Florida. Please contact the DEA at (800) 882-9539 or visit their website.
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Mail/Faxes
Q. Have you received my documents?
A. We will notify you within 30 days of receiving your application. You will receive your first notice which will include your user ID and pass code so you may also check the status of your application via our Online Application Status Check.
Q. Can I mail my application directly to the board office?
A. Please do not mail your application to the board office. To avoid processing delays, please mail your application to Department of Health, P.O. Box 6330, Tallahassee, Florida 32314-6330.
Q. Will you accept copies of required supporting documents?
A. We accept copies of documents that are not required to be submitted directly to us from the original source. For example, we will accept copies of school transcripts. Please refer to your application instructions for details.
Q. Can I fax the required supporting documents?
A. We only accept faxes of documents that are not required to be submitted directly to us from the original source. For example, we will accept faxes of school transcripts. Please refer to your application instructions for details.
Q. Where do I send supporting documents for my application?
A. Please send supporting documents to Department of Health, 4052 Bald Cypress Way, Bin C03, Tallahassee, Florida 32399-3253.
Q. Can I send my application and/or required supporting documents by overnight mail?
A. You may send your application to our post office box by overnight mail via the United States Postal Service (USPS). All other documents may be sent directly to the Board office via the overnight carrier of your choice. However, because all mail is received by a central mailroom, your overnight package may not be delivered to the Board office until the following day.
Send applications to: Department of Health, P.O. Box 6330, Tallahassee, Florida 32314-6330
Send all other documents to: Department of Health, 4052 Bald Cypress Way, Bin C03, Tallahassee, Florida 32399-3253
Q. Where should I send payment for my fees (application fee, background check fee, license fee, and NICA fee)?
A. Please send your payment to Department of Health, P.O. Box 6330, Tallahassee, Florida 32314-6330.
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NICA
Q. What is NICA?
A. NICA stands for Neurological Injury Compensation Association. The Florida Birth-Related Neurological Injury Compensation Association was created by the Florida Legislature in 1988. NICA is a statutory organization that manages the Florida Birth Related Neurological Injury Compensation plan which is used to pay for the care of infants born with certain neurological injuries. This plan is available to eligible families statewide without litigation by eliminating costly legal proceedings, and through professional management of its disbursements. NICA ensures the birth-injured infants receive the care they need while reducing the financial burden on medical providers and families.
Q. Why do I have to pay the Neurological Injury Compensation Association (NICA) fee?
A. Unless you qualify for a NICA exemption (s. 766.314, F.S.), you are required to pay the NICA fee per Florida law. For more information regarding NICA, please see s. 766.301, F.S., through s. 766.316, F.S.
Q. Who is exempt from the Neurological Injury Compensation Association (NICA) fee?
A. You are exempt from paying the NICA fee if you meet the following exemption criteria per s. 766.314, F.S.:
- Resident physicians, assistant resident physicians and interns in postgraduate training programs approved by the Board of Medicine
- Retired physicians who maintain an active license, but who have withdrawn from the practice of medicine
- Physicians who hold a limited license, as defined by s. 458.317, F.S., who do not receive any compensation for medical services
- Physicians employed full-time by the Veterans Administration whose practice is confined to VA hospitals
- Any licensed physician on active duty with the Armed Forces of the United States
- Physicians employed full-time by the State of Florida whose practice is confined to state-owned correctional institutions and state-owned mental health facilities
Proof of qualification for a claimed exemption must be submitted to NICA, P.O. Box 14567, Tallahassee, FL 32317-4567. Please contact NICA at (850) 488-8191 for further information or visit their website.
Q. What happens if I don't pay the Neurological Injury Compensation Association (NICA) fee?
A. NICA will refer you to a collection agency and allow you time to pay. Failure to pay will result in NICA entering a judgment against you. If a judgment is issued, you will be unable to renew your medical license.
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Office Surgery Registration and Inspection Program
Q. What are the laws and rules regulating office surgery in Florida?
A. s. 458.309 (3), F.S. – Office Surgery Registration
Rule 64B-4.003 F.A.C. – Office Surgery Registration Fee
Rule 64B-4.002 F.A.C. – Office Surgery Inspection Fee
Rule 64B8-9.009 F.A.C. – Standard of Care for Office Surgery
Rule 64B8-9.0091 F.A.C. – Requirement for Physician Office Registration and Accreditation
Rule 64B8-9.0092 F.A.C. – Approval of Physician Office Accrediting Organizations
You may also review our website for more information.
Q. What is office based surgery?
A. Any surgical procedure performed in the physician’s office. You may also review Rule 64B8-9.009(1)(d), F.A.C. for more information.
Q. What are the levels of office-based surgery?
A. The levels of surgery are divided into four categories based on the level of anesthesia administered to the patient.
- Level I (Rule 64B8-9.009(3), F.A.C.) – No drug-induced alteration of consciousness other than minimal pre-operative tranquilization of the patient and/or the use of local or oral medication that does not alter the consciousness of the patient.
- Level II (Rule 64B8-9.009(4), F.A.C.) – Any surgery where the patient is placed in a state which allows the patient to tolerate unpleasant procedures while maintaining adequate cardio-respiratory function and the ability to respond purposefully to verbal command and/or tactile stimulation.
- Level IIA (Rule 64B8-9.009(5), F.A.C.) – Any Level II surgery with a maximum planned duration of five minutes or less and in which chances of complications requiring hospitalization are remote.
- Level III (Rule 64B8-9.009(6), F.A.C.) – Any surgery which involves, or reasonably should require, the use of a general anesthesia or major conduction anesthesia and pre-operative sedation. This includes the use of intravenous sedation beyond that defined for Level II office surgery, general anesthesia, loss of consciousness and loss of vital reflexes with probable requirement of external support of pulmonary or cardiac functions or major conduction anesthesia.
Q. Who must register to perform office surgery?
A. Physicians who perform Level II and Level III surgical procedures in the office setting must register the facility and each physician performing procedures at that location. You may also review Rule 64B-4.003(1)(a), F.A.C. for more information.
Q. How do I register to perform office surgery?
A. Please print and fill out the Office Surgery Registration Application (pdf - 266kb). Mail the completed form, along with the required $150.00 fee, to Department of Health, P.O. Box 6330, Tallahassee, FL 32314-6330. You may also contact our Communications Center at (850) 488-0595 to have the form mailed to you. You may also visit our website for more information.
Q. How much is the office surgery registration fee?
A. The fee is $150.00. You may also review Rule 64B-4.003(2), F.A.C. for more information.
Q. How long does the registration process take?
A. Most registration applications can be processed and approved within 30 days of receiving a complete application. Incomplete applications will take longer to process.
Q. What documents are required with the application?
A. The following documents are required:
- Copy of Board certification certificate from American Board Medical Specialties or a Board eligibility letter
- Staff privileges letter with a copy of the delineation of privileges
- Transfer agreement (Level II surgery only)
- Advanced Cardiac Life Support certification for the physician and recovery personnel
- Copy of Basic Life Support/Advanced Certified Life Support certification for assistants
- Copies of all “protocol agreements” between physicians and Advanced Registered Nurse Practitioners and Certified Registered Nurse Anesthetists
Q. What kind of education, training, and background are required before performing office surgery?
A. Physicians are expected to perform only those surgeries for which they are competent to perform. Specific education requirements are listed in Rules 64B8-9.009(4)(b)2.a.b. and 64B8-9.009(6)(b)1.a.b., F.A.C..
Q. Is the physician performing office surgery required to have staff privileges at a hospital? A. Physicians who perform Level III office-based surgery must have staff privileges to perform the same procedures at a hospital licensed under s. 395, F. S. You may also review Rule 64B8-9.009(6)(b)1.a., F.A.C. for more information.
Q. When is a transfer agreement required?
A. A physician performing Level II office surgery needs either staff privileges to perform the same procedures at a licensed hospital or a transfer agreement with a licensed hospital within 30 minutes travel time. You may also review Rule 64B8-9.009(4)(b)1., F.A.C. for more information.
Q. Are physicians required to be certified in Advanced Cardiac Life Support (ACLS)?
A. The surgeon/physician performing surgical procedures and recovery room personnel must be certified in ACLS. One assistant to the surgeon/physician (if needed) must be certified in Basic Life Support (BLS). You may also review Rules 64B8-9.009(4)(b)4. and 64B8-9.009(6)(b)4., F.A.C. for more information.
Q. Who is allowed to provide anesthesia?
A. The surgeon must be assisted by a qualified anesthesia provider. Licensed health care personnel, such as a physician/anesthesiologist, Certified Registered Nurse Anesthetist (CRNA), Physician Assistant (PA), Anesthesiology Assistant (AA) or Registered Nurse (RN) qualified by training in anesthesiology, may assist the surgeon. You may also review Rules 64B8-9.009(4)(b)4. and 64B8-9.009(6)(b)4., F.A.C. for more information.
Q. Can the surgeon administer anesthesia and perform the procedure?
A. A physician cannot administer the anesthesia and perform the surgical procedure. A qualified anesthesia provider is required to administer the anesthesia and cannot perform any other function in the operation room. You may also review Rule 64B8-9.009(4), F.A.C. for more information.
Q. What medication is required to be on the crash cart?
A. The crash cart must include, at a minimum, the following resuscitative medications:
- Adenosine 6 mg/2 ml x 3
- Albuterol Inhaler
- Amiodarone 150 mg x 2
- Atropine 0.4 mg/ml; 3 ml
- Calcium chloride 10%; 10 ml
- Dextrose 50%; 50 ml
- Diphenhydramine 50 mg
- Dopamine 200 mg minimum
- Epinephrine 1:10,000 dilution; 10 ml
- Epinephrine 1:1000 dilution; 1 ml x 3
- Flumazenil 0.1 mg/ml; 5 ml x 2
- Furosemide 40 mg
- Hydrocortisone or Methylprednisolone or Dexamethasone
- Lidocaine 100 mg
- Magnesium sulfate 1 gm x 2
- Naloxone 0.4 mg/ml; 3 ml
- Propranolol 1 mg x 1
- Sodium bicarbonate 50 mEq/50 ml
- Succinylcholine 1 vial
- Vasopressin 20 units x 2
- Verapamil 5 mg x 2
You may also see Rule 64B8-9.009(4)(b), F.A.C. for more information.
Q. What equipment is required in the operating room?
A. Level II office surgeries require the following equipment:
- Full and current crash cart at the location the anesthetizing is being carried out
- A Benzodiazepine must be stocked, but not on the crash cart
- Suction devices, endotracheal tubes, laryngoscopes, etc.
- Positive pressure ventilation device (e.g. Ambu) plus oxygen supply
- Double tourniquet for the Bier block procedure
- Monitors for blood pressure/EKG/Oxygen saturation
- Emergency intubation equipment
- Adequate operating room lighting
- Emergency power source able to produce adequate power to run required equipment for a minimum of two (2) hours
- Appropriate sterilization equipment
- IV solution and IV equipment
You may also see Rules 64B8-9.009(2) and 64B8-9.009(4)(b)3., F.A.C. for more information.
Q. What are the standard dimensions of the operating room?
A. The rules do not specify standard dimensions for the physical plant of an office surgery facility. It is suggested that you contact your local city and county clerk’s office for specific rules and code descriptions and restrictions.
Q. Who is required to be certified in Basic Life Support (BLS)?
A. At least one staff person assisting the surgeon/physician during surgery must be certified in BLS. You may also see Rules 64B8-9.009(4)(b)2.b. and 64B8-9.009(6)(b)1.b., F.A.C. for more information.
Q. Who can assist the surgeon during the procedure?
A. The surgeon must be assisted by a qualified anesthesia provider or a registered nurse (RN) may assist with the anesthesia if the surgeon is Advanced Cardiac Life Support (ACLS) certified. An assisting anesthesia provider cannot function in any other capacity during the procedure. If additional assistance is required by the specific procedure or patient circumstances, it must be provided by a physician, osteopathic physician, RN, licensed practical nurse (LPN) or an operating room technician. You may also see Rule 64B8-9.009(4), F.A.C. for more information.
Q. Who can monitor and supervise the recovery of a patient?
A. Licensed health care providers are required to monitor the recovery of a patient who has been given anesthesia. A physician, osteopathic physician, physician assistant (PA), or a licensed registered nurse (RN) with post-anesthesia training and experience must be available. You may also see Rule 64B8-9.009(4)(b)4., F.A.C. for Level II office surgery and see Rule 64B8-9.009(6)(b)4., F.A.C. for Level III office surgery.
Q. How many health care providers are required in the recovery room?
A. At least two monitors should be in the recovery room, one of which must be certified in Advanced Cardiac Life Support (ACLS). You may also see Rule 64B8-9.009(2)(h)1., F.A.C. for more information.
Q. Is a surgical log required?
A. Yes, a surgical log is required. Copies of the suggested form are available online at the Board of Medicine Web Site. You may also see Rule 64B8-9.009(2)(c), F.A.C. for more information.
Q. What should be recorded on the surgical log?
A. The items required on the surgical log form are:
- Confidential patient identifier
- Time of arrival in the operating suite
- Name of the physician who provided medical clearances
- Surgeon’s name
- Diagnosis
- CPT Codes
- Patient ASA classification
- Type of procedure
- Level of surgery
- Anesthesia provider
- Type of anesthesia used
- Duration of the procedure
- Type of post-operative care
- Duration of recovery
- Disposition of the patient upon discharge
- List of medications used during surgery and recovery
- Any adverse incidents, as identified in Section 458.351, F.S.
You may also see Rule 64B8-9.009(2)(c), F.A.C. for more information.
Q. Where can I get a copy of the Sample Surgical Log form?
A. The suggested surgical log form (pdf - 25kb) is available.
Q. What is an adverse incident?
A. For purposes of reporting to the department, an adverse incident is an event over which the physician or other 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:
- The death of a patient
- Brain or spinal damage to a patient
- The performance of a surgical procedure on the wrong patient
- A procedure to remove unplanned foreign objects remaining from a surgical procedure
- The performance of a wrong-site surgical procedure; the performance of a wrong surgical procedure; or 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 and and if one of the listed procedures in this paragraph 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 transfer of the patient
- Any condition that required the transfer or a patient to a hospital licensed under s. 395, F.S., from any facility or any office maintained by a physician for the practice of medicine which is not licensed under s. 395, F.S.
You may also see Rule 64B9-9.001(1)(a), F.A.C. for more information.
Q. Who is required to report an adverse incident?
A. The report must be submitted by every licensee who was involved in the adverse incident. If multiple licensees are involved in the adverse incident, they may meet this requirement by signing off on one report; however, each signee is responsible for the accuracy of the report. You may also see Rule 64B8-9.001(2) F.A.C. for more information.
Q. Is there a time limitation on reporting adverse incidents?
A. Incident reports shall be postmarked and sent by certified mail within 15 calendar days after the occurrence of the adverse incident.
Q. How can I obtain a copy of the adverse incident reporting form?
A. You may download and print a copy of the Physician Incident Reporting Form (pdf - 56kb)or by calling us at (850) 245-4131.
Q. Where should I send the adverse incident report?
A. Mail the completed incident report by certified mail to Department of Health, Consumer Services Unit, 4052 Bald Cypress Way, Bin #C75, Tallahassee, Florida 32399.
Q. If a death occurs, who should be notified?
A. The county medical examiner should be notified immediately. You may also see Rule 64B8-9.001(3) F.A.C. for more information.
Q. What is the pause/time out rule?
A. The pause/time out rule is intended to prevent wrong site, wrong side, wrong patient and wrong surgeries/procedures by requiring the team to pause prior to the initiation of the surgery/procedure to confirm the side, site, patient identity, and surgery/procedure.You may also see Rule 4B8-9.007, F.A.C. for more information.
Q. Who is required to perform the pause/time out before surgery begins?
A. Both the physician office setting and the facilities licensed under s. 395 F. S., (hospitals and ambulatory surgical centers) are required to perform the pause/time out rule. The physician and surgical team will pause immediately prior to the initiation of any surgical procedure to confirm the patient’s identification, the surgical procedure and correct surgical site. You may also see Rule 64B8-9.007(2)(b), F.A.C. for more information.
Q. What is the definition of a “pediatric patient”?
A. A pediatric patient is a child of 13 years of age or younger. Certification in Pediatric Advanced Life Support is required when treating pediatric patients. You may also review Rule 64B8-9.009(1)(e), F.A.C. for more information.
Q. Which nationally recognized accrediting agencies are accepted by the Department of Health?
A. The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), Accreditation Association for Ambulatory Health Care (AAAHC), and Joint Commission on Accreditation of Healthcare Organizations (JCAHO). You may also see Rule 64B8-9.0091, F.A.C. for more information.
Q. I am accredited with a nationally recognized accrediting agency. What documentation should I submit?
A. Submit a copy of your accreditation certificate and a copy of your accreditation survey with your application and after each inspection to Department of Health, P.O. Box 6330, Tallahassee, FL 32314-6330.
Q. Who is inspected by the Department of Health?
A. When an application for office surgery registration is completed, the physician chooses either an annual inspection by the Department or to hold current accreditation with a national accrediting organization or an accrediting organization approved by the Florida Board of Medicine. You may also review Rule 64B8-9.0091, F.A.C. for more information.
Q. What is the process for the Department of Health inspection?
A. One of our inspectors will contact the facility office at least one week in advance to make an appointment for the inspection. On the day of the inspection, the physician/representative should be available to accompany the inspector. After the inspection, the inspector will go over the survey with the physician/representative and indicate any deficiencies. The physician/representative is required to submit a corrective action plan to the Board of Medicine within 30 days from the date of the inspection. You may also review Rule 64B8-9.0091, F.A.C. for more information.
Q. How much is the inspection fee?
A. The inspection fee is $1500.00 payable after the facility is inspected. An invoice is generated and mailed to the facility for payment of the inspection fee. You may also see Rule 64B-4.002, F.A.C. for more information.
Related entities:
The Health Care Clinic Act, s. 400, F.S., and Rule 59A-33, F.A.C., provides for the regulation of certain physician practices that are not wholly owned by physicians or their immediate family.
For information about health care clinics, hospitals and ambulatory surgery centers, please call the Agency for Health Care Administration at (850) 487-2717.
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Physician Assistants
Q. What is a physician assistant’s (PA) scope of practice?
A. A PA may be delegated tasks within his/her supervising physician’s scope of practice. Please review Rules 64B8-30.012, F.A.C. or 64B15-6.010, F.A.C. for further details.
Q. Is a physician assistant (PA) allowed to write a prescription for a controlled substance?
A. No. PAs are not allowed to prescribe controlled substances under any circumstances.
Q. What requirements must be met for a physician assistant (PA) to prescribe non-controlled substances?
A. A PA must complete a three hour course on prescriptive practice.
Q. What information is required on a pre-printed prescription pad?
A. The names and addresses of the physician(s) and the prescribing number of the Physician Assistant.
Q. Is a physician assistant (PA) required to obtain malpractice insurance?
A. No. The PA is covered under the insurance of his/her supervising physician.
Q. What are the laws and rules regulating physician assistants (PA) in Florida?
A. The laws and rules regulating PAs are listed on our website.
Q. How many physician assistants (PAs) can a medical doctor (MD) or osteopathic physician (DO) supervise?
A. An MD or DO may oversee up to four PAs. However, there are limitations on the number of remote locations at which they can supervise PAs. Please review s. 458.347, F.S., and s. 458.348, F.S., (MDs), and s. 459.022, F.S., and s. 459.025, F.S., (DOs) for more details.
Q. Can a physician supervise a physician assistant (PA) at a different location?
A. Yes, a PA can be supervised indirectly without his/her supervising physician onsite as long as the supervising physician is easily available to communicate with the PA and meets the requirement of s. 458.347, F.S., s. 458.348, F.S., or s. 459.025, F.S.
Q. Can a podiatrist or chiropractor supervise a physician assistant (PA)?
A. No. A PA can only be supervised by a licensed medical doctor or an osteopathic physician.
Q. How long will it take to receive my license?
A. When all required documentation has been received by the Council on Physician Assistants, we will issue your license in approximately 15-30 days.
Q. Do I have to wait until the Council on Physician Assistants meets before I receive my license?
A. No. You will receive your license when all licensure requirements have been met and if there are no issues that need to come before the council.
Q. How often does the Florida Council on Physician Assistants meet?
A. The council meets at the same time as the Board of Medicine. You may view the meeting schedule on our website.
Q. Do I have to notify the department of any supervising physician changes?
A. Yes. A PA must notify the department in writing within 30 days of any changes in his/her supervising physicians, using the Supervision Data Form (pdf - 58kb).
Q. How can I find out if the department has my correct supervising physician(s) on record?
A. The supervising physician(s) on record are listed on your license. You can look up your license using our License Verification page.
Q. What continuing medical education (CME) am I required to complete?
A. A PA must complete two hours of CME in the Prevention of Medical Errors for initial licensure. The course must be approved by the American Medical Association (AMA) or the American Academy of Physician Assistants (AAPA) and can be taken from any provider that offers such approved courses. At the first renewal, the following coursework is required:
- 97 hours of general CME (or current certification by the National Commission on Certification of Physician Assistants (NCCPA))
- A one hour course in HIV/AIDS
- A two hour course in Preventing Medical Errors
At subsequent renewals, the following CME is required:
- 98 hours of general CME (or current certification by the NCCPA)
- A two hour course in Preventing Medical Errors
- If you are a prescribing PA, you are also required to take ten hours of CME in each specialty area of your supervising physician. (These hours are inclusive of the general CME hours.)
- Every third renewal, the PA is also required to take a two hour course on Domestic Violence
For more information regarding CME requirements, please visit our CME webpage.
Q. Can I have an extension on my continuing medical education (CME) audit?
A. No. Florida law does not allow extensions for CME audits.
Q. What are the eligibility requirements for a temporary license?
A. To be eligible for temporary licensure as a physician assistant (PA), you must be a recent graduate of an accredited PA program and be registered to take the first available National Commission on Certification of Physician Assistants (NCCPA) examination.
Q. How long does the "one time extension" period last for a temporary license?
A. The one time extension expires upon the receipt of your National Commission on Certification of Physician Assistants (NCCPA) examination scores. If you fail the examination, the temporary license is no longer valid and you will not receive another license until you have successfully passed the examination.
Q. Where can I take the required three hour prescribing course?
A. Prescribing courses are offered at the University of Florida, Nova Southeastern University, Barry University, and the Florida Academy of Physician Assistants.
Q. Am I required to have a separate prescribing application for each specialty area?
A. Licensed prescribing physician assistants (PA) are required to submit a separate application for each specialty; however, initial prescribing applicants are not.
Q. After I receive my license, am I required to show proof of clinical experience in each of my specialty areas to obtain prescriptive privileges?
A. Yes. You are required to show three months of experience for each specialty area.
Q. Can I practice off base if I am a military physician assistant (PA)?
A. Unless you are licensed as a PA in Florida, you may only practice on the military base.
Q. I am a foreign doctor; can I practice as a physician assistant (PA)?
A. A foreign doctor can ONLY practice as a PA if he/she has completed an accredited two year PA program and has obtained licensure as a PA in Florida.
Q. Is there a state exam that foreign physicians may take to become licensed as a physician assistant (PA)?
A. No. Foreign physicians must complete an accredited two year PA program to be eligible for licensure in Florida.
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