A Florida clinic generally needs physician supervision when an advanced practice registered nurse (APRN) practices under a protocol or when a physician assistant (PA) performs delegated medical services. Florida calls the APRN document a supervisory protocol, rather than a collaborative practice agreement.
There is an exception for qualifying APRNs registered for autonomous practice, but it is limited. It does not remove Florida’s supervision rules for PAs, and it does not automatically authorize every service an autonomous APRN might want to offer.
For clinics hiring a physician, the key questions are:
- Does the provider need supervision for the proposed services?
- Is the physician licensed and appropriately qualified in Florida?
- Does the arrangement fit Florida’s additional-office limits?
- Who will prepare the protocol and submit the required notices?
- What is included in the monthly fee?
This guide answers those questions and explains how to find a Florida collaborating physician.
Florida Requirements at a Glance
| Issue | General Florida rule |
|---|---|
| APRN supervision | An APRN generally practices under an established protocol unless registered and practicing within the autonomous-practice authority in Florida Statute § 464.0123. |
| PA supervision | The autonomous APRN pathway does not apply to PAs. Florida PAs perform medical services delegated by a supervising physician under § 458.347 or the osteopathic counterpart, § 459.022. |
| APRN protocol | The protocol is maintained on-site at the location or locations where the APRN practices. It is not submitted to the Florida Board of Nursing. |
| Physician notice | The supervising physician generally must notify the applicable medical board within 30 days after the protocol begins and within 30 days after it ends. |
| Remote supervision | Florida permits telecommunication to support PA supervision, but remote arrangements still must satisfy the applicable protocol, availability, prescribing, office-location, and scope requirements. |
| Office limits | Limits may apply when an APRN or PA works at an additional medical office without a supervising physician on-site. The cap depends on the type of practice. |
These are general rules. Facility-based practices and certain licensed programs may fall within statutory exemptions, so the clinic’s setting matters.
Do You Need a Collaborating Physician in Florida?
APRNs who are not registered for autonomous practice
Under Florida Statute § 464.012, an APRN who is not practicing autonomously generally performs authorized functions within an established protocol maintained at the practice location. The protocol is entered into with a physician licensed under Chapter 458 or Chapter 459, or a dentist licensed under Chapter 466 when appropriate to the practice.
If several supervising physicians practice in the same group, the statute allows the APRN to enter a protocol with at least one physician in that group. That does not eliminate the need to define who is responsible and available for supervision.
APRNs registered for autonomous practice
Florida’s autonomous-practice pathway is narrower than full, unrestricted independent practice. To register, an APRN generally must:
- hold an active, unencumbered Florida APRN license;
- have no disqualifying disciplinary action reported within the preceding five years;
- document at least 3,000 clinical practice hours under qualifying physician supervision during the five years before applying;
- complete at least three graduate-level semester hours in differential diagnosis and three in pharmacology within the preceding five years; and
- satisfy Florida’s financial-responsibility requirement or qualify for an exemption.
The statute authorizes autonomous APRN practice in primary care, including family medicine, general pediatrics, and general internal medicine as defined by board rule. It also contains a separate autonomous-practice pathway for certified nurse midwives.
Autonomous registration should not be treated as a blanket exemption for every clinic model. A med spa, IV hydration practice, specialty clinic, or clinic offering obesity-treatment services must evaluate whether each proposed service falls within the practitioner’s statutory authority and other applicable Florida laws. The answer depends on the services—not only the name on the clinic’s sign.
Physician assistants
Florida’s APRN autonomous-practice statute does not apply to PAs. A Florida PA is licensed to perform medical services delegated by a supervising physician. Florida defines supervision as responsible supervision and control; except in an emergency, the physician must be physically present or easily available for consultation and direction. Easy availability can include telecommunication.
The supervising physician or physician group must also be qualified in the medical areas in which the PA will perform services. Under current law, one physician may not supervise more than 10 licensed PAs at the same time.
What Must the Florida Supervisory Protocol Cover?
Florida requires the APRN protocol to be maintained on-site at every practice location covered by it. The Florida Board of Nursing no longer receives or maintains these protocols.
Florida’s APRN protocol guidance says the exact content is determined by the APRN and supervising physician. In practice, a defensible protocol should clearly identify:
- the APRN and supervising physician;
- the practice locations covered;
- the patient population and services within scope;
- the medical acts and prescribing authority being delegated or supervised;
- how and when consultation will occur;
- physician availability and coverage arrangements;
- record-review or quality-assurance processes, when applicable; and
- amendment and termination procedures.
The document should reflect the real operation of the clinic. A generic template that conflicts with the services actually delivered, the physician’s availability, or the clinic’s locations creates avoidable risk.
One specialty rule deserves particular attention: under § 464.012, a psychiatric nurse may prescribe psychotropic controlled substances for the treatment of mental disorders only within an established protocol with a psychiatrist.
The 30-Day Physician Notice Requirement
The protocol stays at the practice, but the physician still has a separate notice duty.
An allopathic physician must file notice within 30 days after entering an APRN protocol and within 30 days after terminating it under Florida Statute § 458.348. An osteopathic physician has parallel duties under § 459.025.
That distinction matters operationally:
- The protocol is maintained on-site and is not filed with the Board of Nursing.
- The physician notice goes to the physician’s applicable licensing board.
- A second notice is due when the protocol ends.
The original draft overstated what happens after a missed deadline. Florida law establishes the deadline, but the consequences of a late filing depend on the facts and any board action. A clinic or physician that discovers a missed filing should submit the required notice promptly and obtain Florida healthcare counsel when needed.
Florida’s Additional-Office Limits
The often-cited office caps are conditional. They apply when a physician supervises an APRN or PA at a medical office other than the physician’s primary practice location and the practitioner is not under the on-site supervision of a supervising physician there.
Under §§ 458.348 and 459.025, the general limits are:
- Primary health care: up to four additional offices.
- Specialty health care: up to two additional offices.
- Primarily dermatologic or skin care, including aesthetic skin care: one additional office.
The aesthetic-office category carries extra conditions. The supervising physician must be board-certified or board-eligible in dermatology or plastic surgery. The additional office must be within 25 miles of the physician’s primary practice location or in a contiguous county, and the distance between any of the offices may not exceed 75 miles.
At covered additional offices, the practice must post the physician’s regular on-site schedule and the hours the office operates without a supervising physician present. The statutes also contain exemptions for specified licensed facilities and programs, so clinics should not apply the caps without first classifying the setting correctly.
These limits are not a simple statewide cap on every relationship a physician may have. They are medical-office rules triggered by location, practice type, and the absence of on-site supervision.
How Much Does a Collaborating Physician Cost in Florida?
Florida does not set a statutory monthly fee. The price is negotiated and depends on the actual work and risk in the arrangement.
Published 2026 market pages point to a broad working range, but their numbers are not directly interchangeable:
- NP Collaborator reports an all-in Florida median around $499 per month based on more than 250 contracts, with many arrangements in a narrow band around that figure.
- Single Aim Health reports average Florida physician compensation of about $614 per month and describes a broader $450-to-$750 market range.
One source describes clinic cost; the other describes physician pay. Platform fees, services included, and methodology can differ. For that reason, roughly $500 to $750 per month is a reasonable planning range for many standard Florida arrangements, not a guaranteed quote or legal benchmark. Higher-complexity or higher-liability arrangements may cost more.
Factors that commonly affect price include:
- clinic type and services;
- number and type of supervised practitioners;
- prescribing responsibilities, including controlled substances;
- physician specialty or board-status requirements;
- number and location of offices;
- expected consultation and chart-review workload;
- on-site presence or travel; and
- agreement, compliance, insurance, and payment support included in the fee.
Before comparing quotes, ask whether the number covers only physician compensation or the entire service. Our collaborating physician fees guide explains the major pricing variables.
What to Verify Before Hiring a Florida Physician
A low monthly price does not make an arrangement compliant. Before signing, verify:
- License status. Confirm an active Florida MD or DO license and review public disciplinary information.
- Clinical fit. Make sure the physician is qualified in the medical services being supervised.
- Specialty rules. Confirm psychiatrist involvement for the statutory psychiatric-nurse prescribing rule and board-certified or board-eligible status for covered aesthetic offices.
- Office eligibility. Count every additional office and test any applicable distance, posting, or exemption rule.
- Protocol accuracy. Match the protocol to the clinic’s actual services, providers, locations, prescribing, and consultation process.
- Notice ownership. Document who tracks the 30-day start and termination notices.
- Availability. Put response expectations, backup coverage, record access, and escalation steps in writing.
- Insurance and termination. Review professional liability, indemnity, payment, and transition terms with qualified counsel.
For a more detailed legal overview, see our Florida collaborating physician requirements guide.
How to Find a Collaborating Physician in Florida
Start by documenting the clinic rather than searching for a physician based only on price. A matching team should know:
- the provider type and credentials;
- every Florida practice location;
- the services and patient population;
- whether controlled substances are involved;
- the expected launch date;
- whether on-site physician time is needed; and
- the desired consultation and review cadence.
Collaborating Physician uses this information to evaluate fit, introduce a Florida-licensed physician, and structure the onboarding process around the clinic’s circumstances. Review our Florida physician matching service or request a match.
Physicians interested in Florida opportunities can apply to join the network. There is no platform fee for physicians.
Frequently Asked Questions
Do nurse practitioners need a collaborating physician in Florida?
Generally, an APRN who is not registered and practicing within Florida’s autonomous-practice authority needs an established protocol. Autonomous registration is limited by the statute’s eligibility and scope rules; it is not a blanket authorization for every clinic service.
Can an autonomous APRN open a med spa in Florida without a physician?
Do not assume so based on autonomous registration alone. Florida limits autonomous APRN practice to statutory areas, and individual aesthetic services may be governed by additional medical-practice, prescribing, facility, ownership, and supervision rules. The clinic should obtain a service-specific Florida legal review before opening.
Do physician assistants need supervision in Florida?
Yes. Florida PAs perform medical services delegated by a supervising physician. The physician must be physically present or easily available for consultation and direction, and telecommunication can satisfy easy availability when the overall arrangement complies with Florida law.
Is a Florida APRN protocol filed with the Board of Nursing?
No. It is maintained on-site at the practice location or locations. The supervising physician separately files the applicable start and termination notices with the physician’s licensing board.
How much does a collaborating physician cost in Florida?
Published market data supports using approximately $500 to $750 per month as a planning range for many standard arrangements. The final fee can rise with specialty requirements, multiple providers or locations, controlled-substance prescribing, on-site duties, and additional compliance support.
Can a Florida physician supervise more than one office?
Yes, but conditional caps may apply at additional medical offices without on-site physician supervision. The general limits are four additional primary-care offices, two specialty-care offices, and one qualifying dermatologic or aesthetic-skin-care office. Exemptions and extra geographic or posting rules may apply.
Must a Florida collaborating physician be physically present?
Not in every arrangement. Florida recognizes supervision supported by physician availability and telecommunication in some contexts. However, certain procedures, facilities, office categories, or agreement terms can require on-site or direct supervision. The clinic must analyze the actual services and setting.
What happens if the 30-day notice was filed late?
The statutes set a 30-day deadline but do not support a universal statement about the consequence of every late filing. File the required notice promptly, preserve the relevant records, and seek Florida healthcare counsel if there may be regulatory exposure.
Final Takeaway
Florida’s rules turn on provider type, autonomous-practice status, services, specialty, and location. The safest sequence is to classify the practice first, confirm the physician’s qualifications and office capacity, prepare a protocol that reflects reality, and track the physician’s 30-day notices.
If your clinic is ready to begin, request a Florida physician match. Matches often occur within 24 to 48 hours, subject to license, specialty, availability, and compliance review.
Disclaimer: This article is for general educational information and is not legal or medical advice. Laws, rules, and board procedures change. Verify current requirements with the Florida Legislature, Florida Board of Nursing, Florida Board of Medicine, and Florida Board of Osteopathic Medicine, and consult qualified Florida healthcare counsel about your specific arrangement.
