Provider Demographics
NPI:1225353907
Name:MAUTNER, STARR KOSLOW (MD)
Entity Type:Individual
Prefix:DR
First Name:STARR
Middle Name:KOSLOW
Last Name:MAUTNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SUNSET DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4828
Mailing Address - Country:US
Mailing Address - Phone:786-662-4775
Mailing Address - Fax:
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 130
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4828
Practice Address - Country:US
Practice Address - Phone:786-662-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1249422086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology