Provider Demographics
NPI:1104611367
Name:BOOST YOUR HEALTH AND WELLNESS
Entity type:Organization
Organization Name:BOOST YOUR HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-665-0603
Mailing Address - Street 1:626 N ALAFAYA TRL STE 206
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4056 ALCOTT CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4884
Practice Address - Country:US
Practice Address - Phone:916-665-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty