Carlos Manuel Rodriguez III, D.D.S
Individual provider Active NPI Dentist · Bushnell, FL
NPI 1932602182 · NPPES record last updated Jun 11, 2026
Key facts
- NPI
- 1932602182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN23484 (FL)
- Practice address
- 65 CR 542W
Bushnell, FL 33513-4515 - Phone
- (352) 569-0100
- NPI assigned
- Mar 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN23484 | FL | MD | Dentist |
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bushnell Family and Cosmetic Dentistry PLLC | Current | Accepting new patients | |
| Sumter Value Dental PLLC | Current | Accepting new patients | |
| Dental Associates LTD of Wisconsin | Past | Accepting new patients | |
| Joseph Brent Novak, DMD,PA | Past | Accepting new patients |
Locations
65 CR 542W
Bushnell, FL 33513
Phone (352) 569-0100
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN23484 | FL | Yes |
Addresses
Primary practice location
65 CR 542W
Bushnell, FL 33513-4515
Mailing address
18216 Sandy Pointe Dr
Tampa, FL 33647-3328
Phone (305) 733-2600
Other practice location 1
410 E Belt Ave
Bushnell, FL 33513-5208
Phone (352) 569-4962
Other providers in Bushnell, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.