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Change of Address Notice - Certificate of Exemption

A certificate of exemption is valid only for the licensee, provider and location for which the license is issued. A new certificate will not be issued for the new location until a change of address application is received and approved by the agency.  You must report a facility's change of location to the agency within 21 calendar days from the effective date of the change, as required by s. 408.810 (3), Florida Statutes (2009).

To request a change of address, select the link below and complete Parts 1 and 6 ONLY of the application. Attach a copy of current Certificate of Exemption.

(NO FEE REQUIRED)

APPLICATION AND INSTRUCTIONS

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Health Facility Regulation | Health Care Clinics | Important Notices & Alerts | HCC Statutes/Rules | Applications and Instructions | Medical/Clinic Director Info | Background Screening Info | Find a HCC Clinic