Healthcare Provider Details

I. General information

NPI: 1275066797
Provider Name (Legal Business Name): ERICA LEE BENSON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 S PARKER RD
AURORA CO
80014-3110
US

IV. Provider business mailing address

407 AVENUE K SE
WINTER HAVEN FL
33880-4126
US

V. Phone/Fax

Practice location:
  • Phone: 303-752-2662
  • Fax:
Mailing address:
  • Phone: 863-294-3504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT3698
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC5366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: