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NPI Code Detail

MEDICARE: MRS. CHIYE ONODERA DUFFY MPT, C/NDT, CIMI

MEDICARE:  MRS. CHIYE ONODERA DUFFY  MPT, C/NDT, CIMI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical TherapistPT 20885CA
22251P0200XPediatric Physical TherapistPT 29683FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912280447
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHIYE ONODERA DUFFY MPT, C/NDT, CIMI
Provider Business Mailing Address
First Line : 5558 W. BAYSHORE DRIVE
Second Line :
City : PORT ORANGE
State : FL
Zip : 32127-6116
Country : US
Telephone Number : 949-256-6918
Fax Number :
Provider Business Practice Location Address
First Line : 900 N SWALLOW TAIL DR STE 107
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-6103
Country : US
Telephone Number : 386-446-9935
Fax Number : 386-446-7777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 06/17/2021

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Directions to “ MRS. CHIYE ONODERA DUFFY MPT, C/NDT, CIMI” Practice Location

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