Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Alexis Tam Mugno, DPM

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104480284

Dr. Alexis Tam Mugno, DPM is a Podiatry in Orange Park, Florida. Graduated from Barry University School of Podiatric Medicine in 2019, 7 years ago. Practices with Southeast Orthopedic Specialists LLC, a 145-clinician group, works from 12 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Trained at
Barry University School of Podiatric Medicine
Licensed in
FL
In the registry since
2019
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

2300 Park Ave Ste 206
Orange Park, FL 32073-5573
Phone: (904) 634-0640
Fax: (904) 634-0203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (11)

  • 4565 Us Highway 17 Ste 200, Fleming Island, FL 32003-4823 — (904) 634-0640
  • 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 — (904) 634-0640
  • 2627 Riverside Ave Ste 300, Jacksonville, FL 32204-4717 — (904) 634-0640
  • 15255 Max Legget Pkwy Ste 5300, Jacksonville, FL 32218-7274 — (904) 634-0640
  • 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 — (904) 634-0640
  • 10475 Centurion Pkwy N Ste 305, Jacksonville, FL 32256-5004 — (904) 634-0640
  • 1611 Nw 12th Ave, Miami, FL 33136-1005 — (904) 866-0280
  • 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 — (904) 634-0640
  • 1690 Us Highway 1 S Ste F, St Augustine, FL 32084-6024 — (904) 634-0640
  • 216 Southpark Cir E Ste 216, St Augustine, FL 32086-5135 — (904) 634-0640
  • 3055 County Road 210 W Ste 110, St Johns, FL 32259-7001 — (904) 634-0640

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence PO4300 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104480284
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPM
Sole proprietorNo
NPI enumeratedApril 24, 2019
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolBARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduated 2019 (7 years in practice)
Group practice Southeast Orthopedic Specialists Llc — 145 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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