Starting a Medical Practice in Florida: Legal Essentials for Physicians & Healthcare Entrepreneurs
Launching a medical practice can be the most rewarding move of your career but it’s also a legal minefield if you don’t structure it correctly from day one. In this episode of the Di Pietro Partners Podcast, David Di Pietro, managing partner and CEO of Di Pietro Partners, about the must-know legal steps for doctors and healthcare entrepreneurs starting a practice in Florida.
David is a nationally recognized trial attorney who has appeared on Fox News, CBS, and other outlets for legal insight. He’s represented both plaintiffs and defendants in high-stakes matters involving physicians, hospitals, surgery centers, and healthcare businesses across Florida.
Choose the Right Entity (and understand S-Corp is a tax status, not an entity)
First step: decide LLC/PLLC vs. corporation.
David often recommends LLC/PLLC for medical practices because they’re more flexible as you grow (e.g., adding service lines under one tax ID). Many physicians say “I’m an S-Corp,” but that’s actually an IRS tax election that can apply to either an LLC or a corporation.
Why it matters:
- Easier multi-unit structuring and roll-ups under one umbrella
- Cleaner compliance alignment with federal/state safe harbors
- Future-proofing for growth or sale
Know Your Regulators: DOH (professionals) & AHCA (facilities)
In Florida, professional licensure runs through the Florida Department of Health (DOH) and the relevant board (e.g., Board of Medicine for MDs, Board of Osteopathic Medicine for DOs, Board of Nursing for RNs/ARNPs, Board of Podiatric Medicine, etc.). Board members are appointed by the Governor and set the rules for each profession.
Facilities (hospitals, ASCs, nursing homes, many specialty providers) are regulated by AHCA the Agency for Health Care Administration.
Bottom line:
- DOH/Boards = the people (the professional license)
- AHCA = the place (the facility license)
If you operate without the correct license, you can be accused of practicing without a license (a crime), and AHCA can seek an injunction to shut you down.
Specialty Practices & Healthcare Businesses (DME, Home Health, ASCs)
Starting a physician office is different from launching a DME supplier, home health agency, or ambulatory surgery center. These businesses often require additional AHCA licensure and carry higher audit risk.
Physician-owned ventures may face fewer hurdles because the owner is already licensed—but structure still matters.
Non-physician owners typically must obtain the appropriate facility or provider license via DOH or AHCA before providing services.
Takeaway: Map your business model to the correct license pathway early to avoid costly delays or shutdowns.
Staffing: Scope of Practice & Supervision Rules
Medical assistants can perform tasks like phlebotomy (drawing blood), but cannot perform invasive procedures such as injectables.
Nurse practitioners (ARNPs) may perform certain procedures (e.g., injectables like Botox) that RNs cannot but supervision/collaboration requirements can apply.
Action item: Build written scope-of-practice protocols and supervision workflows that match Florida law before day one.
Non-Competes in Florida
Unlike some states, Florida generally enforces non-compete agreements if they protect a legitimate business interest and are reasonable in time and geography.
- A system drawing patients from several counties may justify a wider geographic scope.
- Overbroad language isn’t automatically void; courts can narrow it to what’s reasonable.
- Physicians should negotiate non-competes and related terms before signing with a group or hospital.
Tip: Have a healthcare attorney review and negotiate non-competes, non-solicits, and confidentiality provisions up front.
Insurance & Risk Management: More Than Malpractice
If you have hospital privileges, the standard is often $250,000 / $750,000 (per claim/aggregate). Without hospital work, some doctors carry $100,000 / $300,000.
Going bare (no malpractice coverage) triggers special legal requirements if a judgment is entered against you, you may need to satisfy at least $250,000 to avoid license jeopardy.
Consider cyber liability and other coverages; healthcare data = high-value target.
Practical move: Have a healthcare lawyer review your coverage mix alongside your broker so your policy language matches your real risk profile.
Plan for Growth & Exit From Day One
Private equity is actively acquiring medical practices; clean structures command higher valuations. David regularly sees deals at 5× – 15× EBITDA, with purchase payouts often treated as capital gains rather than ordinary income.
What helps maximize value:
- Tight corporate records and operating agreements
- Compliant billing and HIPAA programs
- Well-drafted physician/partner agreements (with dispute and buy-sell provisions)
- Clear financials and KPIs
How a healthcare lawyer at Di Pietro Partners can help
- Entity formation & operating agreements (PLLC/LLC structures built for scale)
- Licensing with DOH/AHCA and regulatory navigation
- HIPAA policies, consent forms, and compliance frameworks
- Contracting: leases, vendor agreements, payor/credentialing, physician employment
- Partnership/Shareholder agreements with buy-sell and “business-divorce” planning
- Risk & insurance strategy alignment with real operational exposure
- M&A and exit prep: diligence readiness, deal negotiation, tax-sensitive structures