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Providers

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Enrollment Application

If you have questions about completing the online provider enrollment application, please review the Guide for Completing a Medicaid Provider Enrollment Application or call the Florida Medicaid fiscal agent’s Provider Enrollment Unit at 1-800-289-7799, Option 4.



Instructions>Search>Request Type>Identifying Information>Address Information>Type and Specialty>Provider Contracts>Collaboration Agreement>Ownership Certification>Pharmacy Information>Member of the following Groups>Group Pending>Billing Agent Agreement>Claims Submission>Owners and Operators>Payment Method>EFT Agreement>EFT Exception>Records Custodians>Applicant History>Certification>
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