Disclaimer
This material is provided for educational and informational purposes only. It does not constitute legal or medical advice or regulatory guidance. Requirements and interpretations may vary and change over time. Always verify current rules directly with the Florida Board of Medicine, the Florida Board of Pharmacy, and the Florida Department of Health, and seek advice from qualified legal counsel before making decisions or taking action.
Executive Summary (Updated for 2025)
Florida’s regulatory framework for weight loss clinics and telehealth practices is shaped by state laws, federal oversight, and heightened scrutiny around emerging therapies like GLP-1 medications.
Key highlights for 2025:
- Clinical control & ownership. Florida permits non-physician ownership of clinics, but clinics subject to the Health Care Clinic Act must appoint a medical/clinic director (Florida-licensed MD/DO) with specific compliance duties. MSOs may run business ops, but cannot control medical judgment.
- Delegation & prescribing. PAs require a supervising physician and written agreement; APRNs require a written physician protocol unless registered for Autonomous Practice (limited to primary care/midwifery).
- PA supervision cap. A physician may not supervise more than 10 PAs at one time.
- Telehealth. Florida allows synchronous or asynchronous telehealth (e-mail/fax excluded). A telehealth evaluation can establish the patient relationship. Schedule II controlleds are generally not permitted via telehealth (statutory exceptions), but Schedule IV (e.g., phentermine) may be prescribed if all requirements are met. Out-of-state clinicians must register to treat Florida patients.
- Controlled substances. PDMP (E-FORCSE) checks are required before prescribing/dispensing controlled substances; document checks in the record.
- GLP-1 medications. Semaglutide/tirzepatide are not scheduled under Florida law; prescribing must follow FDA/USP compounding and Florida Board of Pharmacy standards.
- Advertising. Florida prohibits false, deceptive, or misleading ads; titles must reflect the individual’s actual licensure.
Quick Compliance Checklist
Clinic structure
Florida’s Health Care Clinic Act requires that each licensed clinic designate a Florida-licensed MD or DO as medical/clinic director. This physician is legally responsible for compliance, supervision, and recordkeeping. An MSO may manage rent, payroll, marketing, and scheduling, but cannot interfere with protocols, clinical staff, or medical decision-making.
Licensure
Every provider must hold an active, unencumbered license. The medical director must be a Florida-licensed physician, and APRNs, PAs, and RNs must all maintain current licenses. If prescribing controlled substances like phentermine, DEA registration is mandatory. Clinics should keep copies of all licenses and renewals available for inspection.
Delegation documents
APRNs who are not autonomous under §464.0123 must practice under a written physician protocol as required by §464.012. PAs must have a supervision agreement in compliance with §458.347. These documents should clearly list duties, prescribing limits, consultation triggers, and QA processes.
Quality assurance
The medical director must ensure QA systems are documented and sustainable. This includes periodic chart reviews, monthly or quarterly QA meetings, and remediation logs. Minutes, sign-in sheets, and corrective action plans demonstrate compliance with F.S. §400.9935 and Board standards, helping defend against inspections or complaints about inadequate supervision.
Telehealth compliance
Telehealth in Florida is governed by F.S. §456.47. Florida-licensed MDs, DOs, APRNs, and PAs can provide telehealth to Florida patients. Out-of-state clinicians must register through the Florida Telehealth Provider Registration Program. Protocols should cover patient identity verification, informed consent, recordkeeping, and communication standards to match in-person care.
Controlled substances
Phentermine and other controlled weight loss medications require DEA registration and PDMP (E-FORCSE) queries before prescribing, per §893.055. The clinic should document each query, medical rationale, and follow-up plan. Logs of PDMP checks protect providers during audits and reduce the risk of sanctions for inadequate monitoring or diversion concerns.
Pharmacy compliance
GLP-1 medications such as semaglutide and tirzepatide are not scheduled but still closely regulated. Clinics must ensure all sourcing, compounding, and dispensing follows FDA/USP standards and Florida Board of Pharmacy rules. Using registered pharmacies and keeping vendor documentation avoids liability.
Advertising review
Florida law (§456.072) prohibits deceptive or misleading health advertising. Clinics may not exaggerate outcomes (e.g., “lose 30 pounds in 30 days”) or allow non-physicians to call themselves “doctor.” Internal review of titles, before-and-after photos, and claims ensures ads reflect reality and comply with Florida statutes.
Read at:
- Florida Statutes (Chapters 400, 456, 458, 464, 465, 893): Florida Senate – Statutes
- FL DOH – Licensing & Regulation
- 2025 Florida Statutes
- Florida DOH – E-FORCSE
- FDA – Human Drug Compounding
- Florida Telehealth Provider Registration Program
The Legal Frame: CPOM and Who Can Be a Medical Director
- Florida does not require physician-only ownership.
- Clinics covered by the Health Care Clinic Act must designate a medical/clinic director (MD/DO) responsible for licensure checks, records, and other statutory duties; MSOs may manage business functions but cannot direct clinical judgment. 🔗 F.S. §400.9935 - The Florida Senate
Who Can Be a Medical Director?
- A Florida-licensed MD or DO in good standing. Specialty is flexible; competence and willingness to oversee delegated acts and QA are essential.
🔗 Florida Board of Medicine | Florida Board of Osteopathic
Delegation & Prescriptive Authority: The Documents That Matter
Delegation of Medical Acts (Procedures, Labs, IV Therapy
Physicians may delegate procedures if the delegate is licensed, trained, and acting within scope.
Protocols should define supervision and emergency procedures (e.g., anaphylaxis plans for IV therapy).
🔗 Florida Board of Medicine – Statutes & Rules
🔗 Florida Board of Nursing – Practice Standards & Protocols
Supervisory/Collaborative Agreements
Required for APRNs (§464.012, F.S.) and PAs (§458.347, F.S.) who prescribe. Agreements should include:
- Authorized drugs/devices (e.g., GLP-1s, phentermine)
- Consultation/referral procedures
- Communication methods (phone, telehealth, in-person)
- Escalation/emergency protocols
- QA & chart review expectations; annual renewal
🔗 Florida Senate – Florida Statutes (search §464.012, §458.347)
Delegation Limits
A physician may supervise no more than 10 PAs at one time (§458.347, F.S.).
No numeric cap for APRNs; they must practice under a physician protocol (§464.012, F.S.) or hold autonomous registration (§464.0123, F.S.).
🔗 Florida Senate – §458.347, Physician Assistants
🔗 Florida Board of Nursing – APRN Protocols & Autonomous Practice
Weight Loss Clinics — Florida Requirements
Who Can Prescribe Weight Loss Medications?
- MD/DO: Florida-licensed physicians have full prescribing authority. A DEA registration is required if prescribing controlled substances such as phentermine.
- APRNs/PAs: May prescribe weight loss drugs under a written protocol or supervision agreement with a physician.
- RNs, estheticians, nutritionists: Cannot prescribe medications under Florida law.
🔗 Florida Board of Medicine – Resources 🔗 Florida Board of Nursing – Practice Standards
Phentermine (Controlled, Schedule IV)
Phentermine is a controlled substance (Schedule IV). Prescribers must hold a DEA registration and query the PDMP (E-FORCSE) before prescribing to patients aged 16 or older. Treatment plans must be documented, individualized, and avoid “cookie-cutter” protocols to withstand regulatory scrutiny.
🔗 Florida Senate – F.S. §893.055, Prescription Drug Monitoring Program
🔗 Florida Department of Health – E-FORCSE PDMP
GLP-1 Medications (Semaglutide, Tirzepatide, etc.)
GLP-1 medications are not classified as controlled substances in Florida. Prescriptions must still comply with FDA/USP compounding rules and Board of Pharmacy standards. Providers may use FDA-approved products or properly sourced compounded versions from 503A/503B facilities when permitted. Careful documentation of indication, follow-up, and informed consent is expected.
🔗 U.S. Food & Drug Administration – Compounding Policies & Rules 🔗 Florida Board of Pharmacy – Regulations
IV Therapy, Supplements, Adjuncts
IV therapy and supplement protocols must be signed and approved by a supervising physician. Clinics should maintain staff competency records, device logs, and conduct emergency drills (e.g., for anaphylaxis). Since IV therapy is considered a medical act, delegation must be clearly documented and within the scope of the delegate’s license.
🔗 Florida Board of Medicine – Statutes & Rules
🔗 Florida Board of Nursing – Practice Standards
Advertising Rules
Misrepresentation of Providers
- Clinics may not advertise non-physicians as “doctors.” Only MDs, DOs, or other properly credentialed providers may use the title. Misuse of professional titles is considered deceptive and can lead to disciplinary action under Florida law.
Misleading or Exaggerated Claims
- Florida law prohibits misleading, deceptive, or exaggerated claims in health advertising. Statements like “Lose 30 pounds in 30 days guaranteed” are considered fraudulent, regardless of disclaimers. Such advertising is enforceable by the Board of Medicine, Board of Nursing, and Florida Attorney General.
Discipline for Scope Violations
- Advertising services outside the scope of licensure (e.g., estheticians offering injectables) can be grounds for discipline under F.S. §456.072. Florida regulators treat scope misrepresentation in advertising as seriously as clinical violations.
🔗The Florida Senate – F.S. §456.072, Disciplinary Grounds
Telehealth in Florida— Compliance Rules
Practitioner–Patient Relationship & Modality
Florida Telehealth Act (F.S. §456.47) governs telehealth encounters. Telehealth may be synchronous (live video) or asynchronous (store-and-forward), but fax and e-mail are excluded. A valid relationship may be established via telehealth if the provider meets the same standard of care as an in-person visit.
Recordkeeping & Standards
Telehealth visits must document patient identity, informed consent, medical history, assessment, and treatment plan. All records must meet the same standard as in-person care and remain accessible to supervising physicians and regulators. HIPAA-compliant platforms are required.
Telehealth Prescribing
Florida restricts telehealth prescribing of certain drugs. Schedule II controlled substances are generally prohibited except in narrow cases (terminal illness, hospice, or specific inpatient care). Schedule IV drugs such as phentermine may be prescribed if clinically justified, with PDMP (E-FORCSE) checks documented.
Out-of-State Clinicians
- Clinicians outside Florida must register with the Florida Telehealth Provider Registration Program before providing telehealth services to Florida patients. Registration ensures oversight, licensure verification, and compliance with state standards.
🔗 The Florida Senate – Bill Summary: Telehealth Prescribing, F.S. §456.47, Telehealth, Analysis of SB 1232 (2023), F.S. §893.055, PDMP Requirements🔗 Florida Board of Medicine – Telehealth Guidance🔗 Florida HealthSource – Telehealth Provider Registration
Enforcement Risks in Florida
Board of Medicine Oversight
The Florida Board of Medicine frequently disciplines providers for inadequate supervision, improper delegation, or missing collaborative agreements. Failing to comply with scope or recordkeeping rules may result in fines, suspension, or license revocation.
Board of Pharmacy Enforcement
The Florida Board of Pharmacy monitors compounding, sourcing, and advertising of medications. Noncompliance with state or federal pharmacy laws (e.g., compounding without FDA/USP compliance) can trigger investigations or sanctions.
DEA Compliance
The DEA enforces federal controlled substance rules. Prescribers must maintain DEA registration, properly document prescribing, and adhere to federal prescribing limits. Violations include improper prescribing of phentermine or failing to maintain records.
Civil Risk
- Providers also face civil liability. Malpractice suits, deceptive trade practice claims, and consumer protection actions often follow noncompliant prescribing or misleading advertising. Good documentation, accurate advertising, and QA programs are the best defenses.
🔗 Florida Board of Medicine – Resources🔗 Florida Board of Pharmacy – Regulations🔗 U.S. DEA – Diversion Control Division
FAQs
Can a nurse practitioner run a weight loss clinic in Florida?
Yes, as a business/MSO. Medical services must remain under physician control; prescribing requires a protocol unless the APRN is registered for autonomous practice (primary care/midwifery).
Can GLP-1s be prescribed via telehealth?
Yes, if the telehealth encounter meets F.S. §456.47 and clinic protocols are followed.
Is phentermine prescribing allowed via telemedicine?
Yes, with PDMP checks, appropriate documentation, and a clinically sufficient evaluation.
Do supervisory agreements need to list specific drugs?
Yes. Agreements should explicitly authorize drug categories (e.g., GLP-1s, Schedule IV anorectics) and set communication/escalation/QA terms.
How We Help Florida Clinics
- Licensed Florida physicians matched to clinic needs.
- Turnkey APRN protocols and PA supervision agreements compliant with Florida law.
- Quality assurance systems: chart reviews, QA agendas, documentation trackers.
- Telehealth workflows aligned with F.S. §456.47 and e-prescribing.
- Drug-specific compliance: GLP-1 prescribing, phentermine safeguards, compounding and advertising review.
- MSO alignment to ensure physician control of medical decisions.
Areas We Serve
Who We Serve
- Nurse Practitioners (NPs): Collaborative agreements, prescriptive authority, compliance support.
- Registered Nurses (RNs): Oversight for medspas, wellness centers, weight-loss programs.
- Physician Assistants (PAs): Supervision, protocols, chart audits.
- Estheticians: Safe treatment protocols under physician approval.
Florida Resources & References (Primary Sources)
- Florida Board of Medicine – statutes, rules, licensing, telehealth: https://flboardofmedicine.gov
- Florida Board of Nursing – APRN protocols, HB 607/Autonomous APRN: https://floridasnursing.gov
- Florida Board of Osteopathic Medicine – rules/licensure for DOs: https://floridasosteopathicmedicine.gov
- Florida Board of Pharmacy – prescribing/dispensing/compounding: https://floridaspharmacy.gov
- Florida Telehealth Provider Registration Program: https://flhealthsource.gov/telehealth
- Florida DOH – E-FORCSE® PDMP: https://www.floridahealth.gov/statistics-and-data/e-forcse/index.html
- Florida DOH – Electrolysis & Laser Hair Removal: https://www.floridahealth.gov/licensing-and-regulation/electrolysis/laser/index.html
- Florida Statutes (Online Sunshine) – chapters commonly used here: 400, 456, 458, 459, 464, 893: https://www.flsenate.gov/Laws/Statutes
- FDA – Human Drug Compounding (503A/503B): https://www.fda.gov/drugs/human-drug-compounding/human-drug-compounding-policies-and-rules
- DEA – Diversion Control Division: https://www.deadiversion.usdoj.gov
Bolton M. Harris, J.D., is a seasoned attorney with a formidable background in criminal law and a focus on healthcare law and compliance. As the in-house legal counsel at Medical Director Co., Harris brings a unique blend of prosecutorial experience and regulatory expertise to support healthcare professionals across Texas. Her career spans roles as a prosecutor in multiple counties and now as a trusted advisor on the legal intricacies of medical practice operations.
Education & Early Career
Bolton Harris completed her undergraduate studies at Southern Methodist University (SMU) in 2013. During her time at SMU, she was not only a dedicated student but also a competitive athlete on the university’s women’s swimming team. She went on to earn her Juris Doctor from Texas A&M University School of Law in 2016 and became a member of the Texas Bar that same year. Armed with a strong academic foundation and discipline honed as a student-athlete, Harris embarked on a career in criminal law immediately after law school.
Prosecutorial Experience in Texas
Bolton Harris began her legal career in public service as a criminal prosecutor. She served as an Assistant District Attorney in multiple jurisdictions, where she quickly rose through the ranks and handled a broad spectrum of cases. Some highlights of her prosecutorial career include:
- Assistant District Attorney, Dallas County, Texas: Prosecuted a high volume of criminal cases in one of the state’s busiest DA offices, gaining extensive trial experience in both misdemeanor and felony courts.
- Assistant District Attorney, Ellis County, Texas: Continued to hone her courtroom advocacy skills, known for meticulous case preparation and a tenacious pursuit of justice on behalf of the community.
- Assistant District Attorney, Navarro County, Texas: Broadened her legal expertise by handling diverse criminal matters in a smaller county, working closely with law enforcement and community leaders to uphold the law.
Through these roles, Harris built a reputation for being a tough but fair advocate. She brought numerous cases to trial and developed an in-depth understanding of the criminal justice system. This distinguished prosecutorial background laid a strong foundation for the next phase of her career in the private sector.
Healthcare Law & Compliance at Medical Director Co.
After her tenure as a prosecutor, Harris shifted her focus to healthcare law, applying her legal acumen to the medical field. She recognized that the same attention to detail and tenacity that served her in criminal law could benefit healthcare providers navigating complex regulations. Embracing this new direction, Harris became well-versed in the intricate laws governing medical practices – from licensing requirements to patient safety and privacy standards – and is passionate about helping practitioners stay compliant.
In her current role as the in-house attorney for Medical Director Co., Bolton Harris oversees all legal and compliance matters for the organization and its clients. Medical Director Co. is a nurse-owned firm that connects nurse practitioners (NPs), physician assistants (PAs), and registered nurses with qualified medical directors and collaborating physicians, offering fast placements and comprehensive compliance support for healthcare practices. Harris ensures that each of these partnerships and clinical ventures adheres to all applicable state and federal laws. She is responsible for drafting and reviewing collaborative practice agreements, advising on regulatory requirements, and providing ongoing legal counsel as clients establish and grow their clinics. Drawing on her prosecutorial eye for risk management, Harris proactively identifies potential legal issues and addresses them before they escalate, giving healthcare professionals peace of mind.
Bolton M. Harris’s multifaceted expertise – spanning high-stakes courtroom litigation to detailed healthcare compliance – makes her a formidable legal ally. Whether advocating in front of a jury or guiding a medical practice through regulatory hurdles, she remains committed to the highest standards of the legal profession. Her blend of courtroom-tested skill and healthcare law knowledge ensures that clients of Medical Director Co. receive elite-level counsel and steadfast protection in an ever-evolving legal landscape.
