MEDICARE: CLEARWATER ROLFING LLC

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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1215878111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARWATER ROLFING LLC

Provider Business Mailing Address
First Line	:	203 WHISPER LAKE RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5547
Country	:	US
Telephone Number	:	352-709-6537
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 WHISPER LAKE RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5547
Country	:	US
Telephone Number	:	352-709-6537
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	QAESAR EL HAJ
Credential	:
Telephone Number	:	352-709-6537

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	04/03/2026

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Directions to “CLEARWATER ROLFING LLC ” Practice Location

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