Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Peter A Conrique

Individual provider Athletic Trainer · NPI 1720198435

Peter A Conrique is an Athletic Trainer in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
Specialties on file
2

Practice location Address checks out

12961 N Main St Ste 201 & 202
Jacksonville, FL 32218-2769
Phone: (904) 757-2474
Fax: (904) 757-5541
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT25868 (FL)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1720198435
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESSeptember 14, 2010
Mailing address55801 Bear Run Rd, Callahan, FL 32011-8514

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