Written Protocol · NP
Florida Written Protocol for Nurse Practitioners
Required. The Written Protocol is the written instrument Florida law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
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 a Florida Written Protocol must contain
Governed by the Florida Board of Nursing and the Florida Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Unless the Nurse Practitioner is separately registered for autonomous practice under Section 464.0123, Florida Statutes, the Nurse Practitioner shall practice within the framework of a written protocol established with the Physician, as required by Section 464.012, Florida Statutes. The protocol shall be maintained at every location where the Nurse Practitioner practices under it and shall be made available to the Florida Board of Nursing upon request.
The Physician shall notify the Florida Board of Medicine (or Board of Osteopathic Medicine, as applicable) in writing of the establishment or termination of the protocol within thirty (30) days, using the Board's supervision notification form. The Physician and the Nurse Practitioner shall retain the protocol and any related practice records for at least five (5) years, as required for practitioner records under Section 456.057, Florida Statutes, and shall produce them to the applicable Board upon request.
- The Written Protocol on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Section 465.1865, Florida Statutesstatute
Collaborative pharmacy practice for chronic health conditions -- certification, required agreement contents, Board filing, and professional liability insurance requirements.
- Section 458.347, Florida Statutesstatute
Caps the number of Physician Assistants a supervising physician may supervise at one time (raised from four to ten by 2021 c. 2021-118, Laws of Fla.).
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
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
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.