Providers use this page to complete an enrollment application to become a participating provider in the Florida Medicaid program. The application uses a wizard to guide applicants through the enrollment form. An in-progress application can be saved and completed at a later time.

Please reference the Provider General Handbook, Chapter 2, for general requirements that apply to most provider types when enrolling as a Florida Medicaid provider. Applicants must meet all the provider requirements and qualifications and their practices must be fully operational before they can be enrolled as Medicaid providers.

If you have ever been enrolled as a Florida Medicaid provider you must submit a paper application. The enrollment forms are available from the Enrollment link. The forms can be printed, completed, and sent in to Florida Medicaid Provider Enrollment.

Specific qualifications for each provider type are listed in service-specific Coverage and Limitations Handbooks.

The Enrollment Wizard will assist with the completion of an application. Required documents, as stipulated in the applicable Handbook sections, may be uploaded with the application. However, Medicaid Provider Agreements (MPA) must contain an original signature and date. Copies and signature stamps are not acceptable; the MPA must be submitted separately. If using the online Enrollment Wizard, please mail your MPA to EDS, indicating the Application Tracking Number provided by the Enrollment Wizard. The application process cannot complete until an accurately completed MPA is received and matched with the online submission.

To begin, click the Enrollment Wizard icon and provide the information requested. If you have any questions regarding completion of the wizard or status of an application, you may contact Provider Enrollment for assistance.

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