Healthcare Provider Details

I. General information

NPI: 1154115053
Provider Name (Legal Business Name): KINXO MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 LEE RD STE 304
WINTER PARK FL
32789-2107
US

IV. Provider business mailing address

1850 LEE RD STE 304
WINTER PARK FL
32789-2107
US

V. Phone/Fax

Practice location:
  • Phone: 407-545-8100
  • Fax:
Mailing address:
  • Phone: 407-545-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KINGSLEY ISIGUZO
Title or Position: FOUNDER,GM, COMPLIANCE OFFICER
Credential:
Phone: 407-545-8100