Provider Demographics
NPI:1053699884
Name:GNECO WILAMO, CYNTHIA (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:GNECO WILAMO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:800-480-5243
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:7800 SHOAL CREEK BLVD STE 118W
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1007
Practice Address - Country:US
Practice Address - Phone:612-407-8880
Practice Address - Fax:512-407-8681
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2599207R00000X, 207RG0300X
CT052727207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008051259Medicaid
CT1053699884OtherCONNECTICARE
CTP5087265OtherOXFORD
CT1053699884OtherMULTIPLAN
CT1053699884OtherUNITED HEALTHCARE
CT1068695OtherWELLCARE
CT4679633OtherAETNA
CT1053699884OtherTRICARE
CT412190OtherHEALTHY CT
CTP01349703OtherRAILROAD MEDICARE
CT1053699884OtherANTHEM
CT8091634OtherCIGNA
CTD400154944Medicare PIN