Individual
DR. ALEXIS TAM MUGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2300 PARK AVE STE 206, ORANGE PARK, FL 32073-5573
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO4300
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114384100
—
FL
Enumeration date
04/24/2019
Last updated
07/28/2025
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