Provider Demographics
NPI:1922787712
Name:ORBITA, MICHAEL SERGIO (DNP, CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SERGIO
Last Name:ORBITA
Suffix:
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10322 LLOYD RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1949
Mailing Address - Country:US
Mailing Address - Phone:832-752-6084
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:676 FUTENMA, GINOWAN, OKINAWA 901-2202, JAPAN
Practice Address - City:OKINAWA
Practice Address - State:AP
Practice Address - Zip Code:96362
Practice Address - Country:US
Practice Address - Phone:819-897-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128480367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered