Renewal Notice - Licensed Clinics
All licensed health care clinics must submit a completed renewal application, with fees, at least 60-days before the license's expiration date.
Failure to timely submit a renewal application and license fee shall result in a $50 per day late fee charged to the licensee by the agency; however, the aggregate amount of the late fee may not exceed 50 percent of the licensure fee or $500, whichever is less. If an application is not received by the Health Care Clinic Unit prior to the expiration date on the license, the clinic will be considered unlicensed and clinic operations cannot resume until a new license is obtained. There are penalties for operating a health care clinic without a valid license. Third-party billing and reimbursement (Medicare, Medicaid, Insurance, etc.) while unlicensed, is unlawful and unenforceable.
New Regulations Effective 7/1/2009: Click here for more information
COMPLETE BOTH APPLICATIONS BELOW:
License Application (AHCA FORM 3110-0013 REVISED)
Application Addendum (AHCA FORM 3110-1024 REV)
