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General NPI Number Information
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NPI Number | 1982238127
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Entity Type | Organization
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Legal Business Name | CRYSTAL HEARING SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 16251 N CLEVELAND AVE STE 8
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-2176
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Country | US
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Telephone | 239-997-8288
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Fax | 239-997-8084
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Provider Business Mailing Address
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Address Line | 16251 N CLEVELAND AVE STE 8
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-2176
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Country | US
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Telephone | 239-997-8288
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Fax | 239-997-8084
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY/OWNER
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Name | DR. CRYSTAL MARIE BROUSSARD
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Credential | AU.D.
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Telephone | 239-997-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231HA2400X
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Taxonomy Name | Assistive Technology Practitioner Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 231HA2500X
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Taxonomy Name | Assistive Technology Supplier Audiologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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