Healthcare Provider Details

I. General information

NPI: 1992610091
Provider Name (Legal Business Name): LUMINAL THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 COLLINS AVE APT 6E
MIAMI BEACH FL
33140-2308
US

IV. Provider business mailing address

5700 COLLINS AVE APT 6E
MIAMI BEACH FL
33140-2308
US

V. Phone/Fax

Practice location:
  • Phone: 510-345-7454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALISHA MENON
Title or Position: MD
Credential: MD
Phone: 510-345-7454