Provider Demographics
NPI:1912280447
Name:DUFFY, CHIYE ONODERA (MPT, C/NDT, CIMI)
Entity Type:Individual
Prefix:MRS
First Name:CHIYE
Middle Name:ONODERA
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MPT, C/NDT, CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5558 W. BAYSHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-6116
Mailing Address - Country:US
Mailing Address - Phone:949-256-6918
Mailing Address - Fax:
Practice Address - Street 1:900 N SWALLOW TAIL DR STE 107
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-6103
Practice Address - Country:US
Practice Address - Phone:386-446-9935
Practice Address - Fax:386-446-7777
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 208852251P0200X
FLPT 296832251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics