A summary of Florida’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes, until the NP qualifies for independent practice.
Physician Involvement: Low
Agreement Name: Established protocol
On-Site Requirements: None for general practice. On-site physician supervision is required only for laser or light-based hair removal, and aesthetic/dermatologic offices are subject to geographic proximity limits.
Chart Review: No requirement (no fixed count).
Controlled Substances: Allowed (Schedules II–V) with a federal DEA registration plus controlled-substance-prescriber self-designation. Schedule II is limited to a 7-day supply (psychiatric-nurse exception).
Reduced Supervision / Transition Requirements: 3,000 clinical practice hours within 5 years qualifies a primary-care NP for independent practice.
Florida NP Collaboration Requirements Summary
Florida requires nurse practitioners (APRNs) to practice within an established protocol with a collaborating physician, unless the NP has completed the state’s experience requirement and registered with the Board as an independent APRN. Day-to-day physician involvement is light: the physician must be available for consultation, but Florida sets no required chart-review count, meeting cadence, or co-signature rule. NPs who complete 3,000 clinical practice hours within five years may register for autonomous (independent) practice in primary care.
Source: Fla. Stat. 464.012; Fla. Stat. 464.0123
Type of Collaborative Relationship
Florida NPs practice within an established protocol with a collaborating physician who must stay reachable for consultation, though ongoing involvement is minimal. There is a path to independence: after 3,000 clinical practice hours within five years, an NP in a qualifying primary-care specialty can register with the Board and practice autonomously. Florida law does not make the collaborating physician automatically responsible for the NP’s care.
Source: Fla. Stat. 464.012; Fla. Stat. 464.0123
What is an NP’s scope of practice in Florida?
Florida NPs may assess, diagnose, treat, and prescribe — including controlled substances — while working within an established protocol with a collaborating physician. Autonomously registered NPs perform these functions independently in primary care.
Do NPs need a collaborating physician in Florida?
Yes. Florida NPs must practice within an established protocol with a collaborating physician, unless they have qualified for and obtained autonomous registration from the Board.
Can NPs practice independently in Florida?
Yes, but only in primary care. After completing 3,000 clinical practice hours within five years and registering with the Board as an autonomous APRN, an NP may practice independently in family medicine, general pediatrics, or general internal medicine.
How many NPs can a physician supervise in Florida?
Florida does not cap the number of NPs by headcount. Instead it limits the number of practice locations a physician may supervise: up to 4 offices beyond the primary site for primary care, 2 for most specialties, and 1 for dermatologic or aesthetic skin-care services.
Who can be a collaborating physician in Florida?
A physician currently licensed in Florida. The collaborating physician must hold an active Florida license as an allopathic (MD) or osteopathic (DO) physician.
Are there proximity or in-person requirements in Florida?
No, for most practice settings. The physician only needs to be reachable for consultation by phone or another communication device. Exceptions apply to dermatologic and aesthetic skin-care offices, which must be within 25 miles of the physician’s primary site or in a contiguous county (and no more than 75 miles away).
Collaboration Agreement Requirements
Florida’s collaboration agreement is called an established protocol, and the NP may only practice within its framework. Florida does not specify the exact contents the protocol must contain, does not require signatures, and does not mandate a backup physician. The protocol must be kept on site at every location where the NP practices.
Source: Fla. Stat. 464.012(3)
What must be included in an NP collaborative agreement in Florida?
Florida sets no specific required contents. The statute requires the NP to practice within the framework of an established protocol but does not prescribe the specific provisions the protocol must contain.
What is the collaborative agreement called in Florida?
It is called an established protocol. Florida also provides a state template for the protocol.
Who has to sign the collaborative agreement in Florida?
Florida sets no signature requirement for the established protocol.
How often must the agreement be reviewed or renewed in Florida?
Florida sets no review or renewal requirement for the established protocol.
Is a backup (covering) physician required in Florida?
No, Florida sets no backup (covering) physician requirement.
Board Filing Requirements
The NP does not file the protocol in Florida; instead, the collaborating physician must submit notice to the Board within 30 days of entering the protocol. The NP may begin practicing when the protocol takes effect, and the physician must also notify the Board within 30 days if the relationship ends. There are no recurring filing requirements.
Source: Fla. Stat. 458.348(1); Fla. Stat. 459.025(1)
Do you have to file the collaborative agreement with the board in Florida?
The agreement itself is not filed. However, the collaborating physician must submit a notice to the Board within 30 days of entering into the protocol with the NP.
Can an NP start practicing as soon as they file in Florida?
Yes. An NP may begin practicing upon entering the established protocol; the physician’s notice to the Board is due within 30 days of the start of the relationship.
What are the termination and notice requirements in Florida?
The collaborating physician must notify the Board within 30 days after terminating the protocol or relationship. Florida provides no leeway period for an unanticipated termination.
Collaboration Compliance
Once the collaboration is active, Florida’s ongoing obligations are light: the collaborating physician must simply be reachable for consultation and advice. Florida sets no required chart-review count, no meeting cadence, no co-signature requirement, and no separate recordkeeping mandate beyond keeping the protocol on site.
Source: Fla. Admin. Code R. 64B9-4.001(14); Fla. Stat. 464.012(3)
How many charts must a collaborating physician review in Florida?
No, Florida sets no chart-review requirement and no fixed count. Co-signing charts is also not required.
How often must an NP and collaborating physician meet in Florida?
No, Florida sets no required meeting cadence. The physician must be able to be contacted when needed for consultation and advice, in person or by communication devices.
How long must collaboration records be kept in Florida?
Florida sets no separate records-retention period for collaboration. The established protocol must, however, be maintained on site at every location where the NP practices.
Prescribing Rules
Florida NPs may prescribe medications, including controlled substances in Schedules II–V, within their established protocol. Controlled-substance prescribing requires a federal DEA registration plus self-designation as a controlled-substance prescriber on the practitioner profile; there is no separate state DEA registration. Several category-specific limits apply, most notably a 7-day cap on Schedule II prescriptions.
Source: Fla. Stat. 893.055(3)(a); Fla. Stat. 456.44(2)(a); Fla. Admin. Code R. 64B9-4.016
Can an NP prescribe controlled substances in Florida?
Yes. Florida NPs may prescribe controlled substances in Schedules II–V, subject to a federal DEA registration, controlled-substance-prescriber self-designation, and the category limits below.
Can an NP prescribe Schedule II drugs in Florida?
Yes, but with strict limits. Schedule II prescriptions are capped at a 7-day supply (except psychiatric medications prescribed by a psychiatric nurse), and NPs generally may not prescribe amphetamines, sympathomimetic amine drugs, or other Schedule II compounds except for narrowly defined conditions such as narcolepsy, hyperkinesis/ADHD, and certain refractory depression.
What schedule drugs can an NP prescribe in Florida?
NPs may prescribe Schedules II–V within their formulary and protocol. Anti-obesity drugs may not be prescribed by NPs, though an NP may be delegated the initial evaluation for such treatment.
Does an NP need a DEA license in Florida?
Yes, a federal DEA registration is required. Florida does not require a separate state DEA registration; the only state-level step is self-designating as a controlled-substance prescriber on the practitioner profile.
Can an NP prescribe independently (without physician sign-off) in Florida?
Yes, no per-prescription physician sign-off is required. NPs prescribe under their established protocol without co-signature, and autonomously registered NPs prescribe fully independently in primary care.
Specialty & Telehealth Requirements
Florida applies specialty-specific rules and a telehealth limit on controlled substances. Autonomous (independent) practice is available only in primary-care specialties, psychiatric nurses have expanded controlled-substance authority, and laser or light-based hair removal requires on-site physician supervision. For telehealth, Schedule II prescribing is restricted to specific circumstances.
Source: Fla. Stat. 464.0123(3); Fla. Stat. 456.47(1)(c)
Are there telehealth or telemedicine requirements for NPs in Florida?
Yes, for Schedule II prescribing. A provider may not use telehealth to prescribe a Schedule II controlled substance unless it is for treating a psychiatric disorder, inpatient hospital treatment, hospice care, or a nursing-home resident.
Are there specialty-specific requirements for NPs in Florida?
Yes. Autonomous practice is limited to family medicine, general pediatrics, and general internal medicine; psychiatric nurses may prescribe psychotropic controlled substances and Schedule II psychiatric medications to patients under 18 beyond the 7-day cap; and laser or light-based hair removal must be performed under on-site physician supervision.
How do you verify a collaborating physician’s license in Florida?
Confirm the physician holds an active Florida license as an MD (Chapter 458) or DO (Chapter 459). Florida’s source rules require current licensure but do not prescribe a specific verification method beyond confirming active, unencumbered licensure.
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