NP · Florida
Collaborative Practice Agreement for Nurse Practitioners in Florida
Yes, a written physician agreement is required. Florida calls it a Written Protocol.
Autonomous-practice registration (§464.0123, enacted 2020) requires ≥3,000 supervised clinical hours within 5 years plus 3 semester hours each in differential diagnosis and pharmacology — but the resulting scope is limited to primary care (family medicine/general pediatrics/general internal medicine), not full APRN scope. Outside that scope, the standard established-protocol model applies.
Independent practice requires: ≥3,000 clinical practice hours under physician supervision, completed within the 5 years immediately preceding registration (§464.0123(1)); 3 graduate-level semester hours (or equivalent) in differential diagnosis, within the preceding 5 years; 3 graduate-level semester hours (or equivalent) in pharmacology, within the preceding 5 years; Active, unencumbered APRN license under §464.012; no disciplinary action under §456.072/§464.018 within the preceding 5 years; Registration with the Florida Board of Nursing (Fla. Admin. Code R. 64B9-4.020).
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
NP under established protocol (non-autonomous, or outside qualifying primary-care scope): No proximity requirement
No codified mileage/radius or on-site standard — the former protocol-standards rule (Fla. Admin. Code R. 64B9-4.010) has been repealed, with no successor rule found. Proximity/availability terms are left to be negotiated within each individual written protocol.
NP registered for autonomous practice under §464.0123, within qualifying primary-care scope: No proximity requirement
No physician relationship at all — practices without supervision or a protocol within the qualifying primary-care scope.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
NP under established protocol (non-autonomous): As needed, in person or via telehealth
Not fixed by statute or rule — the Board of Nursing's official protocol template (floridasnursing.gov/forms/aprn-protocol-format.pdf) uses only generic language: parties 'share equally in the responsibility for reviewing treatment protocols as needed,' with the physician 'available by telephone or by other communication device when not physically available.' Actual cadence is whatever the individual protocol specifies.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Folded into the same established protocol rather than requiring a separately-executed prescriptive-authority document, unlike Texas's PAA framework.
Written agreement
Required
Branches — autonomous-registered NPs (§464.0123) practicing within qualifying primary-care scope need no protocol at all. NPs outside that scope, or not yet registered, need an 'established protocol' (§464.012(3)) — Florida's statutory term, not 'collaborative practice agreement' — maintained on-site wherever the APRN practices.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same no-CPOM-doctrine framework as `pa` — §400.9905(4)(g)'s Health Care Clinic Act exemption explicitly names APRNs licensed under §464.012 among qualifying practitioner-owners, a stronger textual confirmation than found for PA specifically. An autonomous-registered NP practicing within qualifying primary-care scope may own and operate an entity entirely without physician involvement, in either the entity or the clinical relationship.
Legal sources for these rules (7)
- Fla. Stat. § 464.0123 — Autonomous practice by an advanced practice registered nurse
- Fla. Stat. § 464.012 — APRN protocol, prescriptive authority
- Fla. Admin. Code R. 64B9-4.001, R. 64B9-4.020 — Primary-care definition, autonomous-practice registrationsecondary
- Fla. Admin. Code R. 64B9-4.010 — Standards for Protocols (confirmed REPEALED)
- Fla. Stat. § 456.44 — Controlled substance prescribing standards (acute pain)
- Fla. Stat. § 400.9905(4)(g) — Health Care Clinic Act, practitioner-ownership exemption
- Florida Board of Nursing — Official APRN Protocol Format template
What a collaborating physician costs here
Typical monthly cost in Florida
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About Florida's rules
Florida's 2020 autonomous-practice law (§464.0123, ≥3,000 supervised hours + coursework) creates a real independence pathway for NP and CNM — but excludes PMHNP, CRNA, and CNS entirely; CRNA autonomy bills have died three sessions running (2024-2026). Florida has no corporate-practice-of-medicine doctrine (secondary-source consensus) — entity ownership instead turns on the Health Care Clinic Act's §400.9905 exemption mechanics. Supervision ratio/chart-review/meeting-cadence are largely uncodified; PA's 10-supervisee cap is the exception.
Other clinicians in Florida: see the state overview.