=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487564316
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT SBARCEA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2026
-----------------------------------------------------
Last Update Date | 09/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1256 S RACKHAM WAY
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83642-8816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-884-4647
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5143 N YORGASON AVE
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83703-3273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-991-7828
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5581929
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------