How Do I...
UPDATE ADDRESS ONLINE:
- Login to Online Services by selecting your profession from the dropdown menu and entering your User ID and Password
- Your User ID and Password were mailed with your initial license. Please look at the center section and refer to the Online Services Instructions, item #5.
- If you do not have your User ID and Password, click on “Get Login Help“.
- Select “Update Addresses” on the left side of the page
- Enter the new address information
- Once you have entered your new address, click on “Process”. You will receive a confirmation page that displays the updated address.
About Your Practice Location Address
The practice location address will display on the Internet and your license. Your practice location must be a physical location address and must not include a Post Office box. The mailing address will only display on the Internet if you have not provided a practice location address to us. Establishment/Facility Name or Address If the name or address change is for a facility that has changed location, a licensure application must be submitted. See your profession’s web page for additional information.
UPDATE ADDRESS BY MAIL: If you prefer to change your address by mail, please complete the Change of Address. Written requests for address changes must include your name, profession, license number, old address, new address, date of birth, last four digits of your social security number, and your signature.
PROCESSING TIME: If you are submitting an address change request by mail, please allow 5-7 business days for processing. Online requests will be processed within 48 hours. Please Note: An updated license will not be automatically sent. A duplicate license request must be submitted.
You may log in to Provider Services at the following link on MQA’s Online Services Licensee Resource Login Page: www.flhealthsource.gov Click on “Provider Services” (Top left) and “Manage Your License” and then License Certification/Verification. There is a $25 license verification fee, for each request, you may submit online. If you have not logged in since 2015, you may need to create a new portal account. The website will prompt you how to do this. You may also click on the following link to complete a Certification of Licensure order form: https://appsmqa.doh.state.fl.us/IRM00liccert/Default.aspx
You may choose to mail your request, form and required $25 verification fee to:
Department of Health
Division of MQA, Licensing Support Services
P.O. Box 6320
Tallahassee, FL 32314-6320
Additional instructions for submitting a request via mail:
* Include a cashier’s check or money order, payable to the Department of Health, in the amount
of $25.00 for each certification letter requested
* Include name and address where certification is to be sent
*Complete Certification of Licensure order form:
For additional information, please visit our license certification page at: http://www.floridahealth.gov/licensing-and-regulation/public-records/certification/index.html
These requests are processed by the Department’s Licensure Services Unit, not the OT Board office. To follow up on a submitted fee and verification request please contact the Licensure Services Unit at: Phone: (850)245-5773 OR Call our Customer Care Center at: (850) 488-0595; Fax: (850) 245-4444 x5773; Email: MQAOnlineService@flhealth.gov Website: http://flhealthsource.gov/mqa-services
Name changes require legal documentation showing the name change. To change your name, please submit supporting documents, which must be one of the following:
- A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court.
- A divorce decree restoring your maiden name.
- A court order showing the name change (adoption, legal name change, federal identity change).
- A copy of a certificate of naturalization or H1B Employment Visa (Note: Foreign applicants and/or licensees may not have state issued documents)
Any one of these will be accepted unless the department has a question about the authenticity of the document.
If you wish to receive a new license that reflects the name change, you must request a duplicate license. Mail your $25.00 payment request to:
Division of Medical Quality Assurance
Licensure Support Services
P.O. Box 6320
Tallahassee, Florida 32314-6320
For requests by mail, please include your full name as it appears on your license, profession, license number, your new name, your date of birth, the last four digits of your social security number, and your signature. Please submit your name change along with supporting document(s) 5-7 business days to allow processing if you need to renew online.
If you do not require a new license to reflect your new name, you may submit your request online or by mail along with legible supporting document(s) to one of the following:
- Log onto your MQA Online Services Portal account , select “Request Name Change” from the “Manage My License” dropdown menu
- Mailing address – DOH, Division of Medical Quality Assurance, Post Office Box 6320, Tallahassee, Florida 32314-6320
Log into your MQA Online Services Portal account and select Request Duplicate License from the “Manage My License Information” pulldown menu. Review your changes and click “Submit.” Select “Pay Now” to pay the $25.00 fee with a valid credit card.
NOTE: You should receive your duplicate license in the mail in approximately 5-7 business days after your order is complete and your payment is received. If your profession is pending renewal or in a current renewal cycle, you may be asked to renew your license instead of being issued a duplicate license.
Visit our Enforcement Website to download and complete our Unlicensed Activity Complaint Form. Before completing your complaint form, please be sure to review all instructions provided on the first page.
You may learn more about the Complaint process and submit the appropriate complaint forms by visiting our online Enforcement website.
You may visit our online License Verification page. You may utilize this service to see the status of your providers license and whether there are any disciplinary cases or public complaints against the licensee.
You can print a confirmation of license through the Practitioner Login feature of MQA Services. The confirmation is available up to 30 days after you submit your online renewal request. After logging into the system with your User ID and password, select Print Confirmation of License from the navigation bar located on the left.
If you need a written statement on a public record attesting to the record’s genuineness or that it is a true and correct copy, you may fill out the Online Request Form. Be sure to indicate you need a certified copy of the request form. A $25 fee will be charged, in addition to the public record Fees and Charges. Visit our Public Records page for information on how to request certified documents by mail.
Any substantially affected person (i.e. a licensee or applicant) may seek a Declaratory Statement. Declaratory statements regarding an opinion of a board, or the department when there is no board, as to the applicability of a statutory provision, or of any rule or order of the board, or department when there is no board, as it applies to the licensees particular set of circumstances, pursuant to Section 120.565, Florida Statutes. The petition seeking a declaratory statement must state with particularity the licensees set of circumstances and must specify the statutory provision, rule, or order that the licensee believes may apply to the set of circumstances.
You can view, confirm, or make changes to the information that will be published in your Practitioner Profile. In carrying our legislative mandate to publish practitioner profiles, we want to ensure the information that we publish is accurate. Accordingly, we ask that you please review your profile for any changes, corrections, and/or omissions. If you see the statement “The practitioner did not provide this mandatory information”, please provide that information. We will not accept curriculum vitae or resumes in place of you providing specific information. Changes, excluding education and training, year began practicing, and liability claims, can be made to your profile electronically by following the instructions below. You may also submit changes by mail to:
Department of Health
Licensure Support Services
4052 Bald Cypress Way
Tallahassee, Florida 32399-3260
Please note that Section 456.042, Florida Statutes, requires practitioners to update profile information within 15 days after a change of an occurrence in each section of your profile. Attention Newly Licensed Practitioners Section 456.041(7), Florida Statutes, requires you to submit changes to the department within thirty (30) days from receipt of notice. If you do not make changes within thirty (30) days, your profile will be automatically published. Once you have completed your review and made any necessary corrections, click on “Confirm Changes”. The Practitioner Confirmation Page will display the information that will be published online, at which time you must “Confirm” the profile again before the changes will be implemented.
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.