Name changes require legal documentation showing the name change. To change your name, please submit supporting documents, which must be one of the following: (Any one of these will be accepted unless the department has a question about the authenticity of the document)
- A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court.
- A divorce decree restoring your maiden name.
- A court order showing the name change (adoption, legal name change, federal identity change).
- A copy of a certificate of naturalization or H1B Employment Visa (note: foreign applicants and/or licensees may not have state issued documents).
Licensee
If you are a licensee, you may either update your name online or via email/mail. To update online:
- Login to online services by selecting your profession from the dropdown menu and entering your information
- Find the “Manage My License” menu
- Select “Request Name Change” and submit your request along with legible supporting documents
- Once you have entered your new information, click on “Submit”
If you prefer to email or mail in your address change, please complete the update address form and email to: MQAOnlineService@flhealth.gov
Or mail to:
Division of Medical Quality Assurance
Licensure Support Services
4052 Bald Cypress Way
Bin #C10
Tallahassee, Florida 32399-32260
Applicant
If you an applicant, you may either email or mail in your name change, please complete the change name form and email to: MQA.NursingAppstatus@flhealth.gov
or
mail to:
Department of Health
Medical Quality Assurance
Board of Nursing 4052
Bald Cypress Way, Bin C-02
Tallahassee, Florida 32399-3252
PROCESSING TIME: If you are submitting an name change request by mail, please allow 5-7 business days for processing. Online requests will be processed within 48 hours. Please Note: An updated license will not be automatically sent.
The Division of Medical Quality Assurance is now issuing electronic licenses, which enables you to download a PDF copy of your license within two business days. The license can be retrieved in the License Documents menu of your MQA Online Services Portal, https://mqa-vo.doh.state.fl.us/datamart/voservicesportal account. To learn more, please visit the electronic licensing webpage at https://flhealthsource.gov/electronic-licensing/.