Rodolfo Gonzales San Juan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

50652 Issued in HI

Practice address

9300 Dewitt Loop BLDG 1203
Fort Belvoir, VA 22060-5285

Phone

(571) 562-0444

NPI assigned

Sep 13, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1306031232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 STIMSON RD BLDG 8151",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220602225",
            "telephone_number": "703-805-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP BLDG 1203",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-562-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN JUAN",
        "first_name": "RODOLFO",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "CA",
            "license": "2000643163",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "50652",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "MD",
            "license": "20200099687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Kim Sakai
• Lindsey Rose Salis, CCC-SLP
• Ilyas Saloom, PMH-NP
• Pallavi Laxmi Samudrala, MD
• Jennie Samuel, OTD, OTR/L
• Terrel Sanders, M.D.
• Lisa D. Sandy, FNP
• Rachel E Sankey, APRN
• Charles Santos
• Margaret Elyse Santucci, MD

• Registered Nurse in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.