mqa-vo.doh.state.fl.us
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urlscan Pro
204.90.21.227
Public Scan
URL:
https://mqa-vo.doh.state.fl.us/datamart/voservicesportal/
Submission: On January 18 via manual from US — Scanned from US
Submission: On January 18 via manual from US — Scanned from US
Form analysis 1 forms found in the DOM
POST /datamart/voservicesportal/Login/PiiLogin
<form action="/datamart/voservicesportal/Login/PiiLogin" id="PiiLoginForm" method="post">
<div class="row" style="padding-top: 30px">
<div class="col-md-12"></div>
</div>
<div class="row">
<div class="col-md-1"></div>
<div class="col-md-10" align="center">
<h2 style="border-bottom: solid 1px #113366;">Licensed Practitioner Login</h2>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="padding-top: 15px">
<div class="col-md-12"></div>
</div>
<div class="row" style="margin-top: 5px" align="center" id="divLoginInfo">
<div style="width: 100%">
<div>
<div class="row" style="margin-top: 5px" id="divLastName">
<div class="col-md-5" align="right">Licensee's Last Name :</div>
<div class="col-md-6" align="left">
<input autocomplete="off" class="form-control" data-val="true" data-val-length="The field Licensee's Last Name: must be a string with a minimum length of 2 and a maximum length of 30." data-val-length-max="30" data-val-length-min="2"
data-val-required="Licensee's Last Name can't be empty" id="lastName" maxlength="30" name="LastName" placeholder="Last Name" type="text" value="">
<span class="field-validation-valid" data-valmsg-for="LastName" data-valmsg-replace="true" style="color:red"></span>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="margin-top: 10px" id="divSsn">
<div class="col-md-5" align="right">Licensee's SSN :</div>
<div class="col-md-6" align="left">
<input class="form-control" data-val="true" data-val-regex="Invalid Social Security Number" data-val-regex-pattern="^\d{9}|\d{3}-\d{2}-\d{4}$" data-val-required="The Licensee's SSN: field is required." id="ssn" name="SSN"
placeholder="#########" type="password" value="">
<span class="field-validation-valid" data-valmsg-for="SSN" data-valmsg-replace="true" style="color:red"></span>
<span toggle="#ssn-field" class="fa-solid fa-eye-slash field-icon-right toggle-ssn right:10px" title="Click to display actual data"></span>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="margin-top: 10px" id="divDob">
<div class="col-md-5" align="right">Licensee's Date Of Birth :</div>
<div class="col-md-6" align="left">
<div class="form-group">
<div class="input-group date" id="divdateofBirth">
<input autocomplete="off" class="form-control" id="dateofBirth" name="DateofBirth" placeholder="mm/dd/yyyy" type="date" value="">
<span class="field-validation-valid" data-valmsg-for="DateofBirth" data-valmsg-replace="true" style="color:red"></span>
<span class="input-group-addon">
<span class="glyphicon glyphicon-calendar"></span>
</span>
</div>
</div>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="margin-top: 5px; margin-bottom: 20px">
<div class="col-md-5" align="right">
</div>
<div class="col-md-6" align="left">
<div>
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-tkxeiseqzaba" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lec8YcUAAAAADOYRqwnsYUWUdrFLPttD7VQjH_R&co=aHR0cHM6Ly9tcWEtdm8uZG9oLnN0YXRlLmZsLnVzOjQ0Mw..&hl=en&v=Ya-Cd6PbRI5ktAHEhm9JuKEu&size=invisible&cb=iegtfr8gptjd"></iframe>
</div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div><button type="submit" class="g-recaptcha btn btn-info btn-block" style="width:100%" data-sitekey="6Lec8YcUAAAAADOYRqwnsYUWUdrFLPttD7VQjH_R" data-callback="onSubmit" data-size="invisible" id="btnSubmit">Login</button>
<span class="field-validation-valid" data-valmsg-for="InvisibleCaptchaMsg" data-valmsg-replace="true" style="color:red"></span>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="margin-top: 5px; margin-bottom: 20px">
<div class="col-md-1"></div>
<div class="col-md-10" align="left">
<span style="font-style:italic"> NOTE: Not all mobile devices are fully compatible with the online system at this time. It is highly recommended that you have access to a desktop or laptop computer. </span>
</div>
<div class="col-md-1"></div>
</div>
<div class="row" style="padding-top: 30px">
<div class="col-md-12"></div>
</div>
</div>
</div>
</div>
<input name="__RequestVerificationToken" type="hidden" value="CfDJ8IqhUBgtWsNLoVsMhiLiNabDfRmtzZ-h-Z1oYgNhZtbfRK9M-RDzj9QoFddwZyjQmQ5WUp0xCrhd6coQxqORCgnecmNx3W4IIaBjhDHMjxyd7Y1ICDsqBLfp6XREMi1yUDTJMnMe2goLj1G5tkkclMI">
</form>Text Content
MQA Online Services Home | FL HealthSource | File a Complaint | FAQs | Telehealth LICENSED PRACTITIONER LOGIN Licensee's Last Name : Licensee's SSN : Licensee's Date Of Birth : Login NOTE: Not all mobile devices are fully compatible with the online system at this time. It is highly recommended that you have access to a desktop or laptop computer. OTHER USERS LOGIN OPTIONS Create New Applicant Account -------------------------------------------------------------------------------- Business Establishment / School Returning Applicant / Licensee Login Prescription Pad Vendor Login * Click here for Out-of-State Telehealth * Click here for Other Payer Privacy Statement | Disclaimer | Feedback | Email Advisory © 2024 FL HealthSource, All Rights Reserved Florida Department of Health | Division of Medical Quality Assurance Web Portal