Rodolfo Gonzales San Juan, RN
Registered Nurse in Fort Belvoir, VA. Individual provider (NPI-1).
NPI number1306031232
StatusActive
Last updated in NPPESNov 20, 2025
Details
- NPI
- 1306031232
- Entity type
- Individual (NPI-1)
- Name
- Mr. Rodolfo Gonzales San Juan
- Credential
- RN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 13, 2007
- Certification date
- Nov 20, 2025
- Last updated
- Nov 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 50652 | HI | Yes |
| 364SC0200X | Clinical Nurse Specialist, Critical Care Medicine | 2000643163 | CA | |
| 163WG0600X | Registered Nurse, Gerontology | 20200099687 | MD |
Practice location
9300 Dewitt Loop Bldg 1203Fort Belvoir, VA 22060-5285
Phone 571-562-0444
Mailing address
9409 Stimson Rd Bldg 8151Fort Belvoir, VA 22060-2225
Phone 703-805-0113
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