Who can own a med spa in Florida — and who has to supervise it

1. Who is allowed to own a med spa in Florida?

A non-clinician may. Florida does not enforce the corporate practice of medicine doctrine the way Texas, California or New York do, so the management-company-plus-professional-entity split those states force is optional here. What Florida does instead is license the clinic and put a named person on the hook.

Fee-splitting is still prohibited (§ 458.331), so a management fee has to be written as a fee for services rather than a share of the medical revenue. That is the one place where the structure conversation from stricter states does still matter in Florida.

The rules in the rest of this guide are the same five that the Florida clinic rules overview summarises; this page takes the two that decide the entity — the licence and the supervision — in depth.

2. What does a Florida Health Care Clinic licence involve?

An application to the Agency for Health Care Administration, a fee and an inspection, and then a person who owns the compliance.

The Act reaches any entity where health care services are provided and which tenders charges for them (§ 400.9905(1)). Charging the patient is tendering a charge; a cash-pay clinic is inside the Act unless one of the subsection (4) exemptions applies. The two that matter for a med spa are (f), wholly physician-owned and physician-supervised, and (g), wholly owned, supervised and staffed within scope by licensed practitioners. AHCA issues a voluntary certificate of exemption for clinics that qualify; it is not required, but it is the document a landlord, lender or processor will ask for.

A licensed clinic must appoint a medical director or clinic director who agrees in writing to accept legal responsibility for it (§ 400.9935(1)). The statute then lists what that person is responsible for: ensuring every practitioner holds a current, unencumbered Florida licence; serving as the owner of the clinic’s records; conducting systematic reviews of billing; reviewing patient-referral contracts; ensuring compliance with record-keeping and adverse-incident reporting; posting identifying signs and a schedule of charges. It is a real job with real exposure, and it is why licensed clinics pay their directors.

3. Does a Florida med spa need a medical director?

Two different things get called that, and a med spa can need one, both or neither.

The first is the statutory director of a licensed clinic under § 400.9935 — required, in writing, with the duties above. A clinic exempt from the licence has no such role.

The second is the supervising physician that every APRN and PA needs regardless of licence, because Florida limits autonomous APRN practice to primary care (§ 464.0123) and an aesthetics or hormone practice is not that. The APRN works under a protocol kept at the practice site (§ 464.012(3)); the physician files notice with the Board of Medicine within 30 days of entering it (§ 458.348(1)). A physician who delegates to registered nurses carries the same responsibility under § 458.331(1)(w).

An NP-owned med spa, exempt from the licence, therefore still has a supervising physician. The question is not whether, but where that physician is — which is the next section.

4. How close does the supervising physician have to be?

If the physician is on site, or the med spa is the physician’s primary practice location, there is no distance rule. If neither is true, § 458.348(3)(c) applies — and a family-medicine physician cannot fill the role at all.

Subsection (3) governs a physician who supervises an APRN or PA at an office other than the physician’s primary practice location, where the APRN or PA is not under on-site supervision. A physician providing primary care may supervise up to four such offices; a specialist, two. Both paragraphs expressly exclude practices that are primarily dermatologic or skin care, which the statute defines to include aesthetic skin care services.

Those go to paragraph (c). If the services at the office are primarily dermatologic or skin care, other than plastic surgery, the supervising physician must be board-certified or board-eligible in dermatology or plastic surgery; may supervise only one such office beyond their primary place of practice; that office must be within 25 miles of the primary place or in a contiguous county; no two offices may be more than 75 miles apart; and the physician submits every address to the board. The primary practice location is the address on the physician’s published profile (§ 456.041).

This is the rule that decides whether a med spa’s structure works. An NP-run aesthetics office with an off-site internist or family physician as medical director is outside the statute only if one of two things is true: the physician is present while the NP treats, or the office is the physician’s profile address. Otherwise the supervisor has to be a dermatologist or plastic surgeon, nearby, supervising nowhere else.

5. Can a nurse practitioner own a med spa in Florida?

Yes, and it is usually the cleanest structure — with one physician still in it.

A practice wholly owned by licensed practitioners who supervise it and treat within their licence is exempt from the clinic licence (§ 400.9905(4)(g)). The NP owns everything, employs the staff, keeps the revenue, and appoints no statutory director.

What the NP cannot do is practise autonomously, because autonomy under § 464.0123 stops at primary care. So the NP-owned med spa has a protocol with a supervising physician on site (§ 464.012(3)), the physician files notice within 30 days (§ 458.348(1)), and the 25-mile rule applies to that physician exactly as it would to an employed one. Ownership does not change who may supervise; it only changes who is paying them.

The practical result: an NP-owned Florida med spa generally needs one of three things — the physician present during treatment, a dermatologist or plastic surgeon as supervisor within 25 miles supervising no other satellite, or the physician’s profile address at the spa. Decide which before the lease.

6. Who may perform each treatment in Florida?

By licence, not by job title.

The line to hold: chapter 477 covers hair, skin and nails. Anything that breaks the skin or fires a medical device is medicine or nursing.

7. What order should a Florida med spa set this up in?

Owners, then licence, then physician, then protocol, then lease.

First, settle who owns what — that alone decides whether an AHCA licence is needed. Second, if it is, file with AHCA and put the director’s acceptance in writing; if it is not, consider the voluntary certificate of exemption. Third, choose the supervising physician against § 458.348(3)(c): on site, profile address, or dermatology/plastics within 25 miles. Fourth, write the protocol, keep it on site, file the notice within 30 days. Fifth, if you will run lasers with electrologists, write those protocols too. Only then sign the lease, because the address you sign for has just become a regulated fact.

The general version of this sequence, with costs, is in how to start a med spa. What changes when the med spa starts prescribing is in prescribing TRT and GLP-1s at a Florida med spa.

8. Frequently asked questions

Can a non-doctor own a med spa in Florida?
Yes. There is no general corporate-practice bar. A clinic with any non-practitioner ownership needs a Health Care Clinic licence from AHCA and a director who accepts legal responsibility in writing (§ 400.9905, § 400.9935).

Does being cash-pay exempt a clinic from the Health Care Clinic Act?
No. The Act applies to an entity that tenders charges for health care services, and charging the patient is tendering a charge. Only the subsection (4) exemptions take a clinic outside it.

Is the AHCA certificate of exemption required?
No. It is voluntary. Clinics that qualify under § 400.9905(4) commonly obtain one because lenders, landlords and payment processors ask for it.

Can my medical director be in another city?
For a licensed clinic’s statutory director, the statute sets duties rather than a distance. For the physician supervising an NP or PA who injects, § 458.348(3)(c) applies unless the physician is on site or the office is their profile address — and then the supervisor must be a dermatologist or plastic surgeon within 25 miles or a contiguous county.

Can a registered nurse run a med spa in Florida?
An RN may inject under a clinician’s order but cannot prescribe or supervise, so an RN-owned med spa needs a PA, APRN or physician to evaluate and order, and a physician in the supervision chain. Whether the RN-owned entity is exempt from the clinic licence under § 400.9905(4)(g) turns on whether the owner supervises and treats within their own licence — a question for counsel.