MEDICARE: CRESTLINE BUSINESS COMMUNICATION 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1619819844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESTLINE BUSINESS COMMUNICATION LLC

Provider Business Mailing Address
First Line	:	408 TUDOR DR APT 2A
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9474
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 TUDOR DR APT 2A
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9474
Country	:	US
Telephone Number	:	626-618-2238
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANGELA DAWN FOUSEK
Credential	:
Telephone Number	:	626-618-2238

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “CRESTLINE BUSINESS COMMUNICATION LLC ” Practice Location

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